MEDICARE: WILLIAMS CONSULTANT SLP DBA SIMPLY SLP LLC

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
1	252Y00000X	Early Intervention Provider Agency	6201	LA

General Provider Information

NPI Number	:	1710305974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAMS CONSULTANT SLP DBA SIMPLY SLP LLC

Provider Business Mailing Address
First Line	:	3205 CYPRESS VILLAGE DRIVE
Second Line	:
City	:	BENTON
State	:	LA
Zip	:	71006
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	442 LONG ACRE DR
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-8229
Country	:	US
Telephone Number	:	131-835-5698
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DAWN D GUICE
Credential	:	ED.D,CCC-SLP
Telephone Number	:	318-355-6983

Provider Enumeration Date	:	04/03/2014
Last Update Date	:	01/12/2026

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