Basic Information
| Provider Information | |||||||||
| NPI: | 1356098859 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | JOCELYN | ||||||||
| MiddleName: | RUTH | ||||||||
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| Credential: | CF-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 90 HOWARD DR | ||||||||
| Address2: | |||||||||
| City: | SHELBYVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 400658138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026331007 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3918 TENNESSEE AVE STE 108 | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374091354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6156148833 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/04/2022 | ||||||||
| LastUpdateDate: | 03/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 5616 | TN | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | 7537 | TN | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.