Provider Demographics
NPI:1740792654
Name:HAMMONS, KAYLEE (MS/CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:HAMMONS
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1997 ROUTE 17M STE 9
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-5233
Mailing Address - Country:US
Mailing Address - Phone:845-294-4787
Mailing Address - Fax:845-294-4790
Practice Address - Street 1:1997 ROUTE 17M STE 9
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924
Practice Address - Country:US
Practice Address - Phone:845-294-4787
Practice Address - Fax:845-294-4790
Is Sole Proprietor?:No
Enumeration Date:2017-11-01
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027847-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist