Provider Demographics
NPI:1710425681
Name:WILLIAMS, VALERIE PAIGE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:PAIGE
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:PO BOX 1099
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:FL
Mailing Address - Zip Code:32666-1099
Mailing Address - Country:US
Mailing Address - Phone:352-475-3113
Mailing Address - Fax:352-475-5796
Practice Address - Street 1:25727 NE STATE ROAD 26
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:FL
Practice Address - Zip Code:32666-6202
Practice Address - Country:US
Practice Address - Phone:352-475-3113
Practice Address - Fax:352-475-5796
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8697235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist