Provider Demographics
NPI:1922217827
Name:WILLIAMS, CLARE W (AUD)
Entity Type:Individual
Prefix:MS
First Name:CLARE
Middle Name:W
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 BOYDEN ROAD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520
Mailing Address - Country:US
Mailing Address - Phone:508-829-7048
Mailing Address - Fax:508-829-1702
Practice Address - Street 1:52 BOYDEN ROAD
Practice Address - Street 2:SUITE 204
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520
Practice Address - Country:US
Practice Address - Phone:508-829-7048
Practice Address - Fax:508-829-1702
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA374231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5103231Medicaid
MAY28869Medicare UPIN
MA5103231Medicaid