Doctor Name: | SHANNON D. BERRY |
NPI Number: | 1720401714 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 3186 |
Business Practice Address: | 1359 Hidden Ridge Ln Cordova, TN - 380160111 |
Business Phone Number: | 8706922844 |
Business Fax Number: | |
Mailing Address: | 17 Beckys Hideaway St, PINE BLUFF |
State: | AR |
Postal Code: | 716036132 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/27/2014 |
NPI Last Update Date: | 01/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3186 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AR |
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 |