Individual
SHELBY BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
3180 PROFESSIONAL PLZ STE 101, GERMANTOWN, TN 38138-1534
(228) 313-5514
Mailing address
246 PALISADE ST, MEMPHIS, TN 38111-4528
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7203
TN
Other
Enumeration date
09/10/2020
Last updated
11/08/2021
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