Provider Demographics
NPI:1770892671
Name:WILLLIAMS, WAYNEISHA TRREISE (MS, CF - SLP)
Entity type:Individual
Prefix:
First Name:WAYNEISHA
Middle Name:TRREISE
Last Name:WILLLIAMS
Suffix:
Gender:F
Credentials:MS, CF - SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11531 SW 138TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-6204
Mailing Address - Country:US
Mailing Address - Phone:305-804-7047
Mailing Address - Fax:
Practice Address - Street 1:11531 SW 138TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-6204
Practice Address - Country:US
Practice Address - Phone:305-804-7047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ 5208235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist