| Doctor Name: | SHANNON REAVES |
| NPI Number: | 1003150970 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 002388 |
| Business Practice Address: | 6004 Foxland Dr Brentwood, TN - 370275747 |
| Business Phone Number: | 6159709908 |
| Business Fax Number: | |
| Mailing Address: | 6004 Foxland Dr, BRENTWOOD |
| State: | TN |
| Postal Code: | 370275747 |
| Phone Number: | 6159709908 |
| Fax Number: | |
| NPI Enumeration Date: | 11/16/2012 |
| NPI Last Update Date: | 10/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 002388 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |