Provider Demographics
NPI:1710359500
Name:WILLIAMS, SHERYL LYNNE (MS, CCC-A)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:LYNNE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P. O. DRAWER PH
Mailing Address - Street 2:CHINLE COMPREHENSIVE HEALTHCARE FACILITY
Mailing Address - City:CHINLE
Mailing Address - State:AZ
Mailing Address - Zip Code:86503
Mailing Address - Country:US
Mailing Address - Phone:928-674-7716
Mailing Address - Fax:928-674-7705
Practice Address - Street 1:HWY 191 AND HOSPITAL DR.
Practice Address - Street 2:CHINLE HOSPITAL
Practice Address - City:CHINLE
Practice Address - State:AZ
Practice Address - Zip Code:86503
Practice Address - Country:US
Practice Address - Phone:928-674-7096
Practice Address - Fax:928-674-7627
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-20
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.01461231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist