Provider Demographics
NPI:1912458746
Name:GREENLEE, SHANNON RENAE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:RENAE
Last Name:GREENLEE
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Gender:F
Credentials:MA CCC-SLP
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Mailing Address - Street 1:9041 EXECUTIVE PARK DR
Mailing Address - Street 2:SUITE 126
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4621
Mailing Address - Country:US
Mailing Address - Phone:815-988-4473
Mailing Address - Fax:865-769-0801
Practice Address - Street 1:9041 EXECUTIVE PARK DR
Practice Address - Street 2:SUITE 126
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4621
Practice Address - Country:US
Practice Address - Phone:865-693-5622
Practice Address - Fax:865-769-0801
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN6062235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist