Provider Demographics
NPI:1356656722
Name:WILLIAMS, ELIZABETH LEANN (SLP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LEANN
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 1:3673 S TOWER CIR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-5776
Mailing Address - Country:US
Mailing Address - Phone:479-285-4033
Mailing Address - Fax:479-750-3539
Practice Address - Street 1:3291 S THOMPSON ST
Practice Address - Street 2:SUITE C103
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-7043
Practice Address - Country:US
Practice Address - Phone:479-750-3535
Practice Address - Fax:479-750-3539
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2011235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist