Provider Demographics
NPI:1326318049
Name:HANKINS, MONICA LEE (LMT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:LEE
Last Name:HANKINS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 GRANT DR 167096
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72150
Mailing Address - Country:US
Mailing Address - Phone:501-529-1189
Mailing Address - Fax:
Practice Address - Street 1:130 GRANT 167096
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150-6515
Practice Address - Country:US
Practice Address - Phone:501-529-1189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7111225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist