Provider Demographics
NPI:1104378900
Name:PLAY WITH WORDS: SPEECH AND LANGUAGE THERAPY, PLLC
Entity type:Organization
Organization Name:PLAY WITH WORDS: SPEECH AND LANGUAGE THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:336-365-2637
Mailing Address - Street 1:PO BOX 756
Mailing Address - Street 2:
Mailing Address - City:GERMANTON
Mailing Address - State:NC
Mailing Address - Zip Code:27019-0756
Mailing Address - Country:US
Mailing Address - Phone:336-365-2637
Mailing Address - Fax:336-450-1588
Practice Address - Street 1:2896 SHILOH CHURCH RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27105-9742
Practice Address - Country:US
Practice Address - Phone:336-365-2637
Practice Address - Fax:336-450-1588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11283235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty