Provider Demographics
NPI:1831840404
Name:WILLIAMS, TAYLOR RENEE (AUD)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:RENEE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 WEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-5357
Mailing Address - Country:US
Mailing Address - Phone:870-761-9633
Mailing Address - Fax:
Practice Address - Street 1:520 CARSON ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3128
Practice Address - Country:US
Practice Address - Phone:870-336-2175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR201520231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty