Provider Demographics
NPI:1851671176
Name:OVERTON, SHAWN FRANKS (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHAWN
Middle Name:FRANKS
Last Name:OVERTON
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11823 N MONTICELLO DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-2621
Mailing Address - Country:US
Mailing Address - Phone:865-675-5876
Mailing Address - Fax:
Practice Address - Street 1:127 S KENTUCKY ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-2746
Practice Address - Country:US
Practice Address - Phone:865-705-8688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1593235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist