Individual
SHANNON LAUREN WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 672-2824
Mailing address
132 STONE CREEK DR, MADISON, MS 39110-5058
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3778
MS
Other
Enumeration date
02/14/2019
Last updated
02/14/2019
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