MEDICARE: CAROLYN HAYDEN M.S. 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	30000	CA
2	235Z00000X	Speech-Language Pathologist	025150-01	NY

General Provider Information

NPI Number	:	1942926167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN HAYDEN M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	132 PARK PL
Second Line	:
City	:	EAST AURORA
State	:	NY
Zip	:	14052-2312
Country	:	US
Telephone Number	:	716-445-6403
Fax Number	:

Provider Business Practice Location Address
First Line	:	132 PARK PL
Second Line	:
City	:	EAST AURORA
State	:	NY
Zip	:	14052-2312
Country	:	US
Telephone Number	:	716-445-6403
Fax Number	:

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

Provider Enumeration Date	:	10/19/2022
Last Update Date	:	10/19/2022

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Directions to “ CAROLYN HAYDEN M.S. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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