Provider Demographics
NPI:1255175105
Name:WILLIAMS, EMILY LAUREN (CF-SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:LAUREN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 5TH AVE S APT 2
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39701-6717
Mailing Address - Country:US
Mailing Address - Phone:662-372-0282
Mailing Address - Fax:
Practice Address - Street 1:81 WINDSOR BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39702-3143
Practice Address - Country:US
Practice Address - Phone:662-241-5518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS-5244235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist