Provider Demographics
NPI:1831482330
Name:WILLIAMS, KRISTAN NICOLE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KRISTAN
Middle Name:NICOLE
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 1:2301 OHIO DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3927
Mailing Address - Country:US
Mailing Address - Phone:972-964-1500
Mailing Address - Fax:972-964-1200
Practice Address - Street 1:2301 OHIO DR
Practice Address - Street 2:SUITE 130
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3927
Practice Address - Country:US
Practice Address - Phone:972-964-1500
Practice Address - Fax:972-964-1200
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105107235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist