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NPI Code Detail

MEDICARE: KEELY SULLIVAN WILLIAMS

MEDICARE: KEELY SULLIVAN WILLIAMS
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
1235Z00000XSpeech-Language Pathologist4015AR

General Provider Information

NPI Number : 1710375951
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEELY SULLIVAN WILLIAMS
Provider Business Mailing Address
First Line : 6901 FIELDS DR
Second Line :
City : ALEXANDER
State : AR
Zip : 72002-8076
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1401 LABELLE DR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72204-2315
Country : US
Telephone Number : 501-993-4834
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2014
Last Update Date : 06/10/2026

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Directions to “ KEELY SULLIVAN WILLIAMS ” Practice Location

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