Provider Demographics
NPI:1457588261
Name:STRONG, WILLIAM ERIC (MS, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ERIC
Last Name:STRONG
Suffix:
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:UT
Mailing Address - Zip Code:84333-1774
Mailing Address - Country:US
Mailing Address - Phone:435-258-6678
Mailing Address - Fax:435-258-6566
Practice Address - Street 1:1 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:UT
Practice Address - Zip Code:84333-1774
Practice Address - Country:US
Practice Address - Phone:435-258-6678
Practice Address - Fax:435-258-6566
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7312987-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT26-4694416Medicaid
ID26-4694416Medicaid