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General NPI Number Information
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NPI Number | 1568136703
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Entity Type | Individual
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Provider Name | MADELIENE ELIZABETH HANLEY CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 6535 CHESTER AVE
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2247
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Country | US
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Telephone | 352-434-8799
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Fax |
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Provider Business Mailing Address
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Address Line | 11215 N DITMAN AVE
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City | KANSAS CITY
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State | MO
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Zip | 64157-1161
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Country | US
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Telephone | 352-434-8799
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 19132
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License Number State | FL
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