Individual
MRS. SHANON Y BRANTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCD, CCC-SLP
Contact information
Practice address
505 KELSEY DR, JONESBORO, AR 72404-8561
(870) 926-0152
Mailing address
505 KELSEY DR, JONESBORO, AR 72404-8561
(870) 926-0152
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1703
AR
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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