Individual
SHANNON L LOCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
504 N GASCONADE CT, NIXA, MO 65714-8134
(417) 818-0735
Mailing address
504 N GASCONADE CT, NIXA, MO 65714-8134
(417) 818-0735
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2000152074
MO
Other
Enumeration date
04/07/2009
Last updated
07/04/2015
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