Individual
MS. LISA JOAN WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.,CCC/SLP
Contact information
Practice address
4 ARNOLD MALL, ARNOLD, MO 63010-2223
(636) 282-0056
Mailing address
4 ARNOLD MALL, ARNOLD, MO 63010-2223
(636) 282-0056
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
105176
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105176
MISSOURI LICENSE NO.
MO
Enumeration date
08/10/2010
Last updated
08/10/2010
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