Basic Information
| Provider Information | |||||||||
| NPI: | 1952809444 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOGUE | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | ASHLEY | ||||||||
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| Credential: | MCD CFY SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 104 N CEDAR ST | ||||||||
| Address2: | |||||||||
| City: | DYESS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 723309694 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707611345 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1510 BYRUM RD | ||||||||
| Address2: | |||||||||
| City: | BLYTHEVILLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 723158033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8705322600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2018 | ||||||||
| LastUpdateDate: | 01/30/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.