Provider Demographics
NPI:1942926167
Name:HAYDEN, CAROLYN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:HAYDEN
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 1:132 PARK PL
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2312
Mailing Address - Country:US
Mailing Address - Phone:716-445-6403
Mailing Address - Fax:
Practice Address - Street 1:132 PARK PL
Practice Address - Street 2:
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-2312
Practice Address - Country:US
Practice Address - Phone:716-445-6403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30000235Z00000X
NY025150-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist