Provider Demographics
NPI:1205075611
Name:HANKS, SHELLEY MARIE (MA CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:SHELLEY
Middle Name:MARIE
Last Name:HANKS
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 1:906 HARVEST MOON LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-2412
Mailing Address - Country:US
Mailing Address - Phone:469-261-9581
Mailing Address - Fax:
Practice Address - Street 1:10335 CATLETT LN
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:TX
Practice Address - Zip Code:77571-4217
Practice Address - Country:US
Practice Address - Phone:469-261-9581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102152235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist