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General NPI Number Information
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NPI Number | 1477275394
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Entity Type | Individual
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Provider Name | MICHAEL SHAWN WILLIAMS CCC-SLP
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Gender | Male
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Dates
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Enumeration Date | 09/16/2022
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 7350 BROADWAY
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City | DENVER
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State | CO
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Zip | 80221-3610
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Country | US
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Telephone | 281-635-7790
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Fax |
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Provider Business Mailing Address
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Address Line | 2151 KINCAID PL
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City | BOULDER
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State | CO
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Zip | 80304-1900
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Country | US
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Telephone | 281-635-7790
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 102424
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 24458646
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License Number State | CO
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