Provider Demographics
NPI:1356857759
Name:HOGUE, KAYLYN (MCD)
Entity type:Individual
Prefix:
First Name:KAYLYN
Middle Name:
Last Name:HOGUE
Suffix:
Gender:F
Credentials:MCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 COUNTY ROAD 384
Mailing Address - Street 2:
Mailing Address - City:BONO
Mailing Address - State:AR
Mailing Address - Zip Code:72416-8651
Mailing Address - Country:US
Mailing Address - Phone:870-761-1327
Mailing Address - Fax:
Practice Address - Street 1:48 COUNTY ROAD 384
Practice Address - Street 2:
Practice Address - City:BONO
Practice Address - State:AR
Practice Address - Zip Code:72416-8651
Practice Address - Country:US
Practice Address - Phone:870-761-1327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-20
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist