Provider Demographics
NPI:1629199278
Name:WILLIAMS, EILEEN P (MS, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:P
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 COUNTY ROAD 336
Mailing Address - Street 2:
Mailing Address - City:TUSCOLA
Mailing Address - State:TX
Mailing Address - Zip Code:79562-3926
Mailing Address - Country:US
Mailing Address - Phone:325-691-5688
Mailing Address - Fax:
Practice Address - Street 1:510 COUNTY ROAD 336
Practice Address - Street 2:
Practice Address - City:TUSCOLA
Practice Address - State:TX
Practice Address - Zip Code:79562-3926
Practice Address - Country:US
Practice Address - Phone:325-691-5688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105432235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist