Provider Demographics
NPI:1679500714
Name:HINKLEY, INGRID DAWN (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:INGRID
Middle Name:DAWN
Last Name:HINKLEY
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 1:593 ADERHOLD HL
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30602-0001
Mailing Address - Country:US
Mailing Address - Phone:706-542-1300
Mailing Address - Fax:706-542-2929
Practice Address - Street 1:593 ADERHOLD HL
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30602-0001
Practice Address - Country:US
Practice Address - Phone:706-542-1300
Practice Address - Fax:706-542-2929
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003456A235Z00000X
GASLP007623235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200700580Medicaid
IN200600640Medicaid