Individual
MRS. CHARMAINE D HANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC SLP
Contact information
Practice address
3310 LAKELAND HILLS BLVD, LAKELAND, FL 33805-1974
(863) 802-6600
(863) 802-6639
Mailing address
3310 LAKELAND HILLS BLVD, LAKELAND, FL 33805-1974
(863) 802-6600
(863) 802-6639
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA8116
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13500901
CITRUS HEALTHCARE
FL
01
—
244
ATA
FL
01
—
672202496
MEDWAIVER
FL
05
—
891105300
—
FL
Enumeration date
07/07/2006
Last updated
06/24/2013
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