Individual
KELLY WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1214 NATIONAL AVE, LAS VEGAS, NM 87701-4033
(505) 426-8095
Mailing address
594 LAKE MEADE DR, EAST BERLIN, PA 17316-9326
(717) 599-8874
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
SL014509
PA
235Z00000X
Speech-Language Pathologist
Primary
SLP7560
NM
Other
Enumeration date
06/29/2021
Last updated
10/17/2021
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