Provider Demographics
NPI:1326300252
Name:WILLIAMS, LINDSEY ANN (SPEECH AND LANGUAGE)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:SPEECH AND LANGUAGE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-1806
Mailing Address - Country:US
Mailing Address - Phone:660-665-9529
Mailing Address - Fax:
Practice Address - Street 1:1815 E HAMILTON ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-3903
Practice Address - Country:US
Practice Address - Phone:660-665-5691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012002470235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2012002470OtherHEALING ARTS OF MISSOURI
MOB-12 TEMPORARY AUTHOOtherDESE TEACHING CERTIFICATION