Provider Demographics
NPI:1164548384
Name:WILLIAMS, ABBY (SLP)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:WILLIAMS
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 1:3448 RIVER PLACE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-4804
Mailing Address - Country:US
Mailing Address - Phone:614-403-7901
Mailing Address - Fax:
Practice Address - Street 1:775 E JOHNSTOWN RD
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-2115
Practice Address - Country:US
Practice Address - Phone:614-532-5199
Practice Address - Fax:314-532-3199
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 9605235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist