Provider Demographics
NPI:1831512946
Name:WILLIAMS, VIRGINIA (ED D)
Entity type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 CATTLE HAMMOCK RD
Mailing Address - Street 2:
Mailing Address - City:MIDWAY
Mailing Address - State:GA
Mailing Address - Zip Code:31320-6768
Mailing Address - Country:US
Mailing Address - Phone:912-884-4681
Mailing Address - Fax:
Practice Address - Street 1:519 CATTLE HAMMOCK RD
Practice Address - Street 2:
Practice Address - City:MIDWAY
Practice Address - State:GA
Practice Address - Zip Code:31320-6768
Practice Address - Country:US
Practice Address - Phone:912-884-4681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-24
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006048235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist