Provider Demographics
NPI:1871239103
Name:WILLIAMS, LINSEY RAE
Entity Type:Individual
Prefix:
First Name:LINSEY
Middle Name:RAE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINSEY
Other - Middle Name:
Other - Last Name:LITTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2506 HARBECK RD
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5626
Mailing Address - Country:US
Mailing Address - Phone:503-936-5130
Mailing Address - Fax:
Practice Address - Street 1:398 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-3537
Practice Address - Country:US
Practice Address - Phone:907-374-4911
Practice Address - Fax:907-374-4934
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2355S0801X
ORA07372355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant