Provider Demographics
NPI:1609909936
Name:HEMRY, MANDI LYNN (MA CCC SLP)
Entity Type:Individual
Prefix:
First Name:MANDI
Middle Name:LYNN
Last Name:HEMRY
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 W AUBERRY GRV
Mailing Address - Street 2:
Mailing Address - City:JAMESPORT
Mailing Address - State:MO
Mailing Address - Zip Code:64648-7374
Mailing Address - Country:US
Mailing Address - Phone:660-684-6118
Mailing Address - Fax:660-684-6218
Practice Address - Street 1:SCHOOL DIST R 7 TRI COUNTY
Practice Address - Street 2:904 W AUBERRY GRV
Practice Address - City:JAMESPORT
Practice Address - State:MO
Practice Address - Zip Code:64648-7374
Practice Address - Country:US
Practice Address - Phone:660-684-6118
Practice Address - Fax:660-684-6218
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002020207235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist