Provider Demographics
NPI:1457831521
Name:WILLIAMS-WILBANKS, AIMEE REBECCA (SLP ASSISTANT)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:REBECCA
Last Name:WILLIAMS-WILBANKS
Suffix:
Gender:F
Credentials:SLP ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 W LOOP 281 # 281-170
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-4470
Mailing Address - Country:US
Mailing Address - Phone:903-309-3816
Mailing Address - Fax:
Practice Address - Street 1:303 W LOOP 281 # 281-170
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-4470
Practice Address - Country:US
Practice Address - Phone:903-309-3816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX340262355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant