Provider Demographics
NPI:1215335377
Name:SCHAAP-HODGENS, ALEAZE (MS, CCC/SLP, TSSLD)
Entity type:Individual
Prefix:MS
First Name:ALEAZE
Middle Name:
Last Name:SCHAAP-HODGENS
Suffix:
Gender:F
Credentials:MS, CCC/SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3021
Mailing Address - Street 2:2685 MONTAUK HIGHWAY
Mailing Address - City:BRIDGEHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11932-3021
Mailing Address - Country:US
Mailing Address - Phone:631-527-0271
Mailing Address - Fax:
Practice Address - Street 1:2685 MONTAUK HIGHWAY
Practice Address - Street 2:
Practice Address - City:BRIDGEHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11932-3021
Practice Address - Country:US
Practice Address - Phone:631-527-0271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018267235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist