Provider Demographics
NPI:1093727356
Name:WILLIAMS, ANN M (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
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 1:1214 SPRUCE DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4840
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1201 E 15TH ST
Practice Address - Street 2:STE. 304
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-6238
Practice Address - Country:US
Practice Address - Phone:972-424-0148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19123235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7958760Medicare UPIN
TX8T6110Medicare UPIN