Provider Demographics
NPI:1740471689
Name:HUNDLEY, SANDRA HOLMES (SLP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:HOLMES
Last Name:HUNDLEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GLISTENING GLENN CV
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-4119
Mailing Address - Country:US
Mailing Address - Phone:770-463-8461
Mailing Address - Fax:
Practice Address - Street 1:10 GLISTENING GLENN CV
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-4119
Practice Address - Country:US
Practice Address - Phone:770-463-8461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003193235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist