Provider Demographics
NPI:1912335282
Name:HANKA, NANCY (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:HANKA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24697 TRIPLE M RNCH
Mailing Address - Street 2:
Mailing Address - City:HERMOSA
Mailing Address - State:SD
Mailing Address - Zip Code:57744-5063
Mailing Address - Country:US
Mailing Address - Phone:605-255-4906
Mailing Address - Fax:
Practice Address - Street 1:24697 TRIPLE M RNCH
Practice Address - Street 2:
Practice Address - City:HERMOSA
Practice Address - State:SD
Practice Address - Zip Code:57744-5063
Practice Address - Country:US
Practice Address - Phone:605-255-4906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD378-SLP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist