Individual
MRS. SHANNON SMITH COCKRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
104 RUCKER ST., STUART, VA 24171
(276) 694-3163
(276) 694-3170
Mailing address
433 WIDGEON CREEK RD, WOOLWINE, VA 24185-3602
(276) 692-6054
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2203000475
VA
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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