Basic Information
| Provider Information | |||||||||
| NPI: | 1992005755 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | M.A., CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 1288 | ||||||||
| Address2: | 580 FARRINGDOM STREET | ||||||||
| City: | LUMBERTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28359 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102952609 | ||||||||
| FaxNumber: | 9102950026 | ||||||||
| Practice Location | |||||||||
| Address1: | 1163 7 LAKES DR | ||||||||
| Address2: | |||||||||
| City: | WEST END | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27376 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9106735437 | ||||||||
| FaxNumber: | 9106735438 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2010 | ||||||||
| LastUpdateDate: | 07/24/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 4788 | SC | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | 8942 | NC | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.