Provider Demographics
NPI:1124790746
Name:ARGO, SHANNON (SLP)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:ARGO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 LAKELAND VIEW WAY BAY UNIT3
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-5176
Mailing Address - Country:US
Mailing Address - Phone:561-254-0897
Mailing Address - Fax:
Practice Address - Street 1:9800 LAKELAND VIEW WAY BAY UNIT3
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-5176
Practice Address - Country:US
Practice Address - Phone:561-254-0897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-01
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7625235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNW070275Medicaid