Provider Demographics
NPI:1639584261
Name:WILLIAMS, CASEY MARIE (MS CFY-SLP)
Entity Type:Individual
Prefix:MS
First Name:CASEY
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 CRESTON PARK DR
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-1126
Mailing Address - Country:US
Mailing Address - Phone:608-756-9440
Mailing Address - Fax:608-756-9455
Practice Address - Street 1:1323 CRESTON PARK DR
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-1126
Practice Address - Country:US
Practice Address - Phone:608-756-9440
Practice Address - Fax:608-756-9455
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3972-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist