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NPI Code Detail

MEDICARE: MARY REBECCA WILLIAMSON M.S., CCC-SLP

MEDICARE: MARY REBECCA WILLIAMSON M.S., CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12355S0801XSpeech-Language Assistant
2235Z00000XSpeech-Language Pathologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518181551
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY REBECCA WILLIAMSON M.S., CCC-SLP
Provider Business Mailing Address
First Line : 502 E UNION
Second Line :
City : MAGNOLIA
State : AR
Zip : 71753-3669
Country : US
Telephone Number : 870-904-6063
Fax Number :
Provider Business Practice Location Address
First Line : 301 W CALHOUN
Second Line :
City : MAGNOLIA
State : AR
Zip : 71753-3508
Country : US
Telephone Number : 870-234-1597
Fax Number : 870-234-1797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 09/10/2021

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1184876344 — SHELIA R SMITH
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Directions to “ MARY REBECCA WILLIAMSON M.S., CCC-SLP” Practice Location

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