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General NPI Number Information
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NPI Number | 1497029649
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Entity Type | Organization
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Legal Business Name | B WILLIAMS EVALUATIVE
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Dates
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Enumeration Date | 03/06/2012
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Last Update Date | 03/06/2012
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Provider Practice Location Address
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Address Line | 1001 N LIVINGSTON RD
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City | MADISON
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State | MS
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Zip | 39110-8713
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Country | US
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Telephone | 601-750-4796
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Fax | 601-605-4567
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Provider Business Mailing Address
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Address Line | 1001 N LIVINGSTON RD
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City | MADISON
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State | MS
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Zip | 39110-8713
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Country | US
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Telephone | 601-750-4796
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Fax | 601-605-4567
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST/OWNER
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Name | MRS. BRENDA R HAYES-WILLIAMS
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Credential | M.ED CCC-SLP
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Telephone | 601-750-4796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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