Provider Demographics
NPI:1548876311
Name:HOEM, KANDIS LEE (MS SLP)
Entity type:Individual
Prefix:
First Name:KANDIS
Middle Name:LEE
Last Name:HOEM
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 W PARK ST
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:MT
Mailing Address - Zip Code:59725-2350
Mailing Address - Country:US
Mailing Address - Phone:406-533-8998
Mailing Address - Fax:
Practice Address - Street 1:309 W PARK ST
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725-2350
Practice Address - Country:US
Practice Address - Phone:406-533-8998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1234235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist