Provider Demographics
NPI:1255833950
Name:WILLIAMS, BILLIE J
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:J
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 1:925 FELIX ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64501-2706
Mailing Address - Country:US
Mailing Address - Phone:816-671-4000
Mailing Address - Fax:816-671-4013
Practice Address - Street 1:925 FELIX ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64501-2706
Practice Address - Country:US
Practice Address - Phone:816-671-4000
Practice Address - Fax:816-671-4013
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS463161000Medicaid