Healthcare Provider Details

I. General information

NPI: 1326188418
Provider Name (Legal Business Name): REGINA MARIE SCANNELL M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 FOXFIRE CIR
SEYMOUR TN
37865-3168
US

IV. Provider business mailing address

1531 FOXFIRE CIR
SEYMOUR TN
37865-3168
US

V. Phone/Fax

Practice location:
  • Phone: 360-640-9129
  • Fax:
Mailing address:
  • Phone: 360-640-9129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: