Provider Demographics
NPI:1790022200
Name:HOAG, CANDACE LYNN-ESCHLER (MS ED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:LYNN-ESCHLER
Last Name:HOAG
Suffix:
Gender:F
Credentials:MS ED, 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:PO BOX 29
Mailing Address - Street 2:20 WEST STREET
Mailing Address - City:MORRIS
Mailing Address - State:NY
Mailing Address - Zip Code:13808-0029
Mailing Address - Country:US
Mailing Address - Phone:607-263-2611
Mailing Address - Fax:
Practice Address - Street 1:20 WEST STREET
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:NY
Practice Address - Zip Code:13808-0029
Practice Address - Country:US
Practice Address - Phone:607-263-2611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022444-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist