Individual
MRS. ANN BUTLER WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
10325 LANSHIRE DR, DALLAS, TX 75238-3523
(214) 621-3536
Mailing address
10325 LANSHIRE DR, DALLAS, TX 75238-3523
(214) 621-3536
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
102725
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102725
TEXAS SPEECH LANGUAGE PATHOLOGY LICENSE
TX
01
—
12127802
ASHA CERTIFICATE NUMBER
—
Enumeration date
01/16/2020
Last updated
01/16/2020
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