Provider Demographics
NPI:1184172256
Name:WILLIAMS, MANDY (AUD)
Entity type:Individual
Prefix:DR
First Name:MANDY
Middle Name:
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 1:4801 RADFORD AVE STE A
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3541
Mailing Address - Country:US
Mailing Address - Phone:804-215-0001
Mailing Address - Fax:434-299-8892
Practice Address - Street 1:4801 RADFORD AVE STE A
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3541
Practice Address - Country:US
Practice Address - Phone:804-215-0001
Practice Address - Fax:434-299-8892
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001635231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist