Provider Demographics
NPI:1548557416
Name:WILLIAMS, SHEQURIA NATASIA GANDY (MC, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHEQURIA
Middle Name:NATASIA GANDY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MC, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:9041 EXECUTIVE PARK DR STE 126
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4603
Mailing Address - Country:US
Mailing Address - Phone:865-693-5622
Mailing Address - Fax:865-769-0801
Practice Address - Street 1:9041 EXECUTIVE PARK DR STE 126
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4603
Practice Address - Country:US
Practice Address - Phone:865-693-5622
Practice Address - Fax:865-769-0801
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4308235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist