Provider Demographics
NPI:1003942160
Name:WILLIAMS, NANCY LEA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:LEA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:596 ARBOR HOLLOW CIR
Mailing Address - Street 2:#308
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-3409
Mailing Address - Country:US
Mailing Address - Phone:901-262-3733
Mailing Address - Fax:901-754-6186
Practice Address - Street 1:596 ARBOR HOLLOW CIR
Practice Address - Street 2:#308
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-3409
Practice Address - Country:US
Practice Address - Phone:901-262-3733
Practice Address - Fax:901-754-6186
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2585235Z00000X
AR618235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist