Provider Demographics
NPI:1528223575
Name:HENSLEY, JANICE LYNN
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:LYNN
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10052 NORTH CT
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-3624
Mailing Address - Country:US
Mailing Address - Phone:440-546-2456
Mailing Address - Fax:
Practice Address - Street 1:1929 E ROYALTON RD STE A
Practice Address - Street 2:
Practice Address - City:BROADVIEW HTS
Practice Address - State:OH
Practice Address - Zip Code:44147-2868
Practice Address - Country:US
Practice Address - Phone:440-838-0990
Practice Address - Fax:440-838-8440
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 9561235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0849916Medicaid