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Individual

MS. KRISTEN BROOKE SHORES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS,CCC-SLP

Contact information

Practice address
34 GRACEY ST, SPARTA, TN 38583-2046
(931) 836-2211
(931) 836-2230
Mailing address
PO BOX 298, SPARTA, TN 38583-0298
(931) 836-2211
(931) 836-2230

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SP 0000003641
TN

Other

Enumeration date
06/11/2008
Last updated
06/11/2008
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