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NPI Code Detail

MEDICARE: MRS. AMY ANN SHANNON CCC-SLP

MEDICARE: MRS. AMY ANN SHANNON CCC-SLP
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
1235Z00000XSpeech-Language Pathologist0000002472TN

General Provider Information

NPI Number : 1730202672
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY ANN SHANNON CCC-SLP
Provider Business Mailing Address
First Line : 8288 FLORAL SPRING DR
Second Line :
City : CORDOVA
State : TN
Zip : 38016-9611
Country : US
Telephone Number : 901-757-8805
Fax Number :
Provider Business Practice Location Address
First Line : 2805 CHARLES BRYAN RD
Second Line :
City : BARTLETT
State : TN
Zip : 38134-4756
Country : US
Telephone Number : 901-388-4775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. AMY ANN SHANNON CCC-SLP” Practice Location

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