MEDICARE: MRS. SHALANDA YVONNE ROSE-SNEARLEY LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	11026	TN
2	1041C0700X	Clinical Social Worker	8075	TN

General Provider Information

NPI Number	:	1457972572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHALANDA YVONNE ROSE-SNEARLEY LCSW

Provider Business Mailing Address
First Line	:	2013 MONTREAT DR
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134-6613
Country	:	US
Telephone Number	:	901-721-3809
Fax Number	:

Provider Business Practice Location Address
First Line	:	2013 MONTREAT DR
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134-6613
Country	:	US
Telephone Number	:	901-721-3809
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2020
Last Update Date	:	01/16/2025

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