Provider Demographics
NPI:1952887002
Name:WILLIAMS, WENDY W (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:W
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 1:2921 OVERTON RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228-5031
Mailing Address - Country:US
Mailing Address - Phone:804-262-6930
Mailing Address - Fax:
Practice Address - Street 1:9130 STEPHENS MANOR DR
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-5165
Practice Address - Country:US
Practice Address - Phone:804-798-8043
Practice Address - Fax:804-798-8045
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09146124235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist