Provider Demographics
NPI:1073758959
Name:WILLIAMS, ALESIA OKEKE
Entity Type:Individual
Prefix:
First Name:ALESIA
Middle Name:OKEKE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 HUNT DR APT D
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76543-2966
Mailing Address - Country:US
Mailing Address - Phone:512-656-1732
Mailing Address - Fax:
Practice Address - Street 1:2104 HUNT DR APT D
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-2966
Practice Address - Country:US
Practice Address - Phone:512-656-1732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102477235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0031DGOtherBC/BS
74-2745294OtherTAX ID
TX0944746-02Medicaid
74-2745294OtherTAX ID