Provider Demographics
NPI:1871856237
Name:WILLIAMS, JESSICA BLAIR
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:BLAIR
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 WATTERS CREEK BLVD
Mailing Address - Street 2:STE 250
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3770
Mailing Address - Country:US
Mailing Address - Phone:214-585-6739
Mailing Address - Fax:214-585-6739
Practice Address - Street 1:5462 GLEN LAKES DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4308
Practice Address - Country:US
Practice Address - Phone:214-987-4114
Practice Address - Fax:214-239-9030
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist