Provider Demographics
NPI:1215188339
Name:WILLIAMS, KIMBERLY ANN (MS SLP-CCC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1621 BOB WHITE DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-9305
Mailing Address - Country:US
Mailing Address - Phone:785-766-3217
Mailing Address - Fax:785-746-0132
Practice Address - Street 1:3200 MESA WAY STE D
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-2343
Practice Address - Country:US
Practice Address - Phone:785-831-3053
Practice Address - Fax:785-746-0132
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS225100000X, 225X00000X
KS2721235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist