Provider Demographics
NPI:1720425689
Name:WILLIAMS, KARRA SMITH (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KARRA
Middle Name:SMITH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials: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:PO BOX 143
Mailing Address - Street 2:
Mailing Address - City:PACOLET
Mailing Address - State:SC
Mailing Address - Zip Code:29372-0143
Mailing Address - Country:US
Mailing Address - Phone:846-474-1779
Mailing Address - Fax:864-279-6510
Practice Address - Street 1:150 MCDOWELL ST
Practice Address - Street 2:
Practice Address - City:PACOLET
Practice Address - State:SC
Practice Address - Zip Code:29372-2022
Practice Address - Country:US
Practice Address - Phone:864-279-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3456235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist