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Individual

NANCY A SOMODEVILLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5469 SOUTHWOOD DR, MEMPHIS, TN 38120-1928
(901) 761-0021
Mailing address
5469 SOUTHWOOD DR, MEMPHIS, TN 38120
(901) 761-0021

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP2145
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SP2145
HEALTH RELATED BOARD
TN
Enumeration date
04/09/2008
Last updated
04/09/2008
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