Individual
SHANNON REAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6004 FOXLAND DR, BRENTWOOD, TN 37027-5747
(615) 970-9908
Mailing address
6004 FOXLAND DR, BRENTWOOD, TN 37027-5747
(615) 970-9908
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
002388
IA
235Z00000X
Speech-Language Pathologist
Primary
5419
NM
Other
Enumeration date
11/16/2012
Last updated
10/01/2013
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