Provider Demographics
NPI:1053840215
Name:WILLIAMS, SHELLY C (HIS)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:C
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13000 CHENAL PKWY STE 106
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-5259
Mailing Address - Country:US
Mailing Address - Phone:501-227-4327
Mailing Address - Fax:
Practice Address - Street 1:13000 CHENAL PKWY STE 106
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-5259
Practice Address - Country:US
Practice Address - Phone:501-227-4327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR638237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist