MEDICARE: MRS. JANICE LYNN HENSLEY

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	SP 9561	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528223575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANICE LYNN HENSLEY

Provider Business Mailing Address
First Line	:	10052 NORTH CT
Second Line	:
City	:	BRECKSVILLE
State	:	OH
Zip	:	44141-3624
Country	:	US
Telephone Number	:	440-546-2456
Fax Number	:

Provider Business Practice Location Address
First Line	:	1929 E ROYALTON RD STE A
Second Line	:
City	:	BROADVIEW HTS
State	:	OH
Zip	:	44147-2868
Country	:	US
Telephone Number	:	440-838-0990
Fax Number	:	440-838-8440

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

Provider Enumeration Date	:	07/18/2008
Last Update Date	:	09/28/2011

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Directions to “ MRS. JANICE LYNN HENSLEY ” Practice Location

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