Provider Demographics
NPI:1598265498
Name:SLATER-HOGUE, CYNTHIA A (SLP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:SLATER-HOGUE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:A
Other - Last Name:SLATER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MACCC-SLP/L
Mailing Address - Street 1:4203 N MISSION RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIRE
Mailing Address - State:KS
Mailing Address - Zip Code:67226-1470
Mailing Address - Country:US
Mailing Address - Phone:316-253-1331
Mailing Address - Fax:
Practice Address - Street 1:700 MONTEREY PL
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-2266
Practice Address - Country:US
Practice Address - Phone:316-253-1331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3461235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS3461Medicaid