Healthcare Provider Details

I. General information

NPI: 1609482710
Provider Name (Legal Business Name): EMILY WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2020
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7022 SARDIS RD
CHARLOTTE NC
28270-6058
US

IV. Provider business mailing address

1225 ESTATES AVE APT 3201
CHARLOTTE NC
28209-0260
US

V. Phone/Fax

Practice location:
  • Phone: 704-366-8260
  • Fax:
Mailing address:
  • Phone: 864-497-9657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30005722
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: