Provider Demographics
NPI:1356442750
Name:WILLIAMS, AMY E (SPEECH LANGUAGE PATH)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 LADIGO LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76126-6443
Mailing Address - Country:US
Mailing Address - Phone:817-271-1367
Mailing Address - Fax:
Practice Address - Street 1:6801 DAN DANCIGER RD
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-4903
Practice Address - Country:US
Practice Address - Phone:817-294-0350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19840235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist