MEDICARE: CANDACE LYNN-ESCHLER HOAG M.S. ED, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	022444-1	NY

General Provider Information

NPI Number	:	1790022200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDACE LYNN-ESCHLER HOAG M.S. ED, CCC-SLP

Provider Business Mailing Address
First Line	:	PO BOX 29
Second Line	:	20 WEST STREET
City	:	MORRIS
State	:	NY
Zip	:	13808-0029
Country	:	US
Telephone Number	:	607-263-2611
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 WEST STREET
Second Line	:
City	:	MORRIS
State	:	NY
Zip	:	13808-0029
Country	:	US
Telephone Number	:	607-263-2611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2013
Last Update Date	:	01/04/2013

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