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NPI Code Detail

MEDICARE: TANA HANLEY MA, CCC/SLP

MEDICARE:   TANA  HANLEY  MA, 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
1235Z00000XSpeech-Language Pathologist009693-1NY

General Provider Information

NPI Number : 1801022280
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANA HANLEY MA, CCC/SLP
Provider Business Mailing Address
First Line : 201 SPEAR HILL RD
Second Line :
City : LYON MOUNTAIN
State : NY
Zip : 12955-3113
Country : US
Telephone Number : 518-651-5260
Fax Number :
Provider Business Practice Location Address
First Line : 355 W MAIN ST
Second Line :
City : MALONE
State : NY
Zip : 12953-1827
Country : US
Telephone Number : 518-651-5260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2009
Last Update Date : 05/31/2009

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Directions to “ TANA HANLEY MA, CCC/SLP” Practice Location

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