Provider Demographics
NPI:1982957544
Name:WILLIAMS, NANCY L (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:L
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 1:922 DYERBROOK RD
Mailing Address - Street 2:SOUTHERN AROOSTOOK COMMUNITY SCHOOL RSU 50
Mailing Address - City:DYERBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04747
Mailing Address - Country:US
Mailing Address - Phone:207-653-1435
Mailing Address - Fax:
Practice Address - Street 1:922 DYERBROOK RD
Practice Address - Street 2:SOUTHERN AROOSTOOK COMMUNITY SCHOOL RSU 50
Practice Address - City:DYERBROOK
Practice Address - State:ME
Practice Address - Zip Code:04747
Practice Address - Country:US
Practice Address - Phone:617-233-7035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2184SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist