Individual
RAVISHANKAR PRASAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
121 PHYSICIANS DR, JACKSON, TN 38305-6011
(731) 664-5050
Mailing address
4 RACHEL DR, APT # 3, JACKSON, TN 38305-8623
(731) 660-3471
(731) 660-3471
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP0000002867
TN
Other
Enumeration date
10/29/2008
Last updated
10/29/2008
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