Basic Information
| Provider Information | |||||||||
| NPI: | 1639338593 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | BRANDI | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Credential: | M.S. CCC-A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2682 COUNTY ROAD 2512 | ||||||||
| Address2: | |||||||||
| City: | QUINLAN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 754742718 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9038830305 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1320 SUMMER LEE DR | ||||||||
| Address2: | |||||||||
| City: | ROCKWALL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727715443 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2008 | ||||||||
| LastUpdateDate: | 08/11/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 51423 | TX | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.