MEDICARE: MRS. ODETTE MCINTYRE HANKINS M.S., CCC-SLP

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	SP3213	OH

General Provider Information

NPI Number	:	1760717276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ODETTE MCINTYRE HANKINS M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	3505 ROLLING HILLS DR
Second Line	:
City	:	PEPPER PIKE
State	:	OH
Zip	:	44124-5802
Country	:	US
Telephone Number	:	216-595-0403
Fax Number	:	216-595-0403

Provider Business Practice Location Address
First Line	:	3505 ROLLING HILLS DR
Second Line	:
City	:	PEPPER PIKE
State	:	OH
Zip	:	44124-5802
Country	:	US
Telephone Number	:	216-595-0403
Fax Number	:	216-595-0403

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

Provider Enumeration Date	:	10/16/2009
Last Update Date	:	11/13/2011

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