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General NPI Number Information
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NPI Number | 1962227132
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Entity Type | Individual
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Provider Name | VIKKI Y. SPANN PH.D., SLP-CCC
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Gender | Female
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 905 NORTH BROADWAY
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City | SHELBY
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State | MS
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Zip | 38774
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Country | US
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Telephone | 662-545-7243
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 123
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City | SHELBY
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State | MS
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Zip | 38774-0123
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Country | US
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Telephone | 662-545-7243
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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