MEDICARE: MS. NICOLE TOWNLEY WILLIAMS MA, CCC-SLP

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	235Z00000X	Speech-Language Pathologist	5376	LA

General Provider Information

NPI Number	:	1578889952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NICOLE TOWNLEY WILLIAMS MA, CCC-SLP

Provider Business Mailing Address
First Line	:	2110 PINE ST
Second Line	:
City	:	WINNSBORO
State	:	LA
Zip	:	71295-3236
Country	:	US
Telephone Number	:	225-937-8605
Fax Number	:

Provider Business Practice Location Address
First Line	:	12018 COUERON DR
Second Line	:
City	:	SAINT AMANT
State	:	LA
Zip	:	70774-3565
Country	:	US
Telephone Number	:	225-937-8605
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2010
Last Update Date	:	11/25/2020

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Directions to “ MS. NICOLE TOWNLEY WILLIAMS MA, CCC-SLP” Practice Location

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