Provider Demographics
NPI:1518000272
Name:WILLIAMS, RUTH NICHOLSON (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:NICHOLSON
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 38TH ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-2312
Mailing Address - Country:US
Mailing Address - Phone:330-492-8136
Mailing Address - Fax:330-493-1887
Practice Address - Street 1:2100 38TH ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-2312
Practice Address - Country:US
Practice Address - Phone:330-492-8136
Practice Address - Fax:330-493-1887
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP7864235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2095254Medicaid