Basic Information
| Provider Information | |||||||||
| NPI: | 1871882068 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | KATRINA | ||||||||
| MiddleName: | GODDARD | ||||||||
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| Credential: | M.S., LIC-A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4380 GEORGETOWN SQ | ||||||||
| Address2: | SUITE 1002 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303386254 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7702208434 | ||||||||
| FaxNumber: | 7702349979 | ||||||||
| Practice Location | |||||||||
| Address1: | 6630 MCGINNIS FERRY RD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | DULUTH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300972164 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042974230 | ||||||||
| FaxNumber: | 7702320847 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2011 | ||||||||
| LastUpdateDate: | 01/19/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AUD003452 | GA | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.