MEDICARE: WILLIAMS & ASSOC. SPEECH THERAPY GROUP PLLC

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	NV20101203767	NV

General Provider Information

NPI Number	:	1811202278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAMS & ASSOC. SPEECH THERAPY GROUP PLLC

Provider Business Mailing Address
First Line	:	2831 SAINT ROSE PKWY
Second Line	:	SUITE 334
City	:	HENDERSON
State	:	NV
Zip	:	89052-4840
Country	:	US
Telephone Number	:	702-589-4630
Fax Number	:	702-589-4631

Provider Business Practice Location Address
First Line	:	2831 SAINT ROSE PKWY
Second Line	:	SUITE 334
City	:	HENDERSON
State	:	NV
Zip	:	89052-4840
Country	:	US
Telephone Number	:	702-589-4630
Fax Number	:	702-589-4631

Authorized Official
Title or Position	:	CEO
Name	:	ADRIENNE WILLIAMS
Credential	:
Telephone Number	:	702-245-2407

Provider Enumeration Date	:	08/10/2010
Last Update Date	:	08/10/2010

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