Provider Demographics
NPI:1619055977
Name:HANCOCK, SANDRA ONISK (SLP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ONISK
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:ONISK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5501 FORTUNES RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6102
Mailing Address - Country:US
Mailing Address - Phone:919-419-1428
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DR # 7070
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-419-1428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6465235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412197Medicaid