Provider Demographics
NPI:1245050806
Name:HANLEY, SYDNEY SPENCER
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:SPENCER
Last Name:HANLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:SPENCER
Other - Last Name:CADOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1040 N QUINCY ST APT 507
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-5623
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5910 WILSON BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-1554
Practice Address - Country:US
Practice Address - Phone:703-536-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202010382235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist