Individual
COREY LAINE FAWCETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3971 KNIGHT ARNOLD RD, MEMPHIS, TN 38118-3004
(901) 500-6146
Mailing address
589 MARIANNA ST, MEMPHIS, TN 38111-1706
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6028
TN
Other
Enumeration date
06/21/2021
Last updated
06/21/2021
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