Provider Demographics
NPI:1124843040
Name:WILLIAMS, SARAH M (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 PARADISE BLVD NW # 66042
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-4106
Mailing Address - Country:US
Mailing Address - Phone:505-720-3930
Mailing Address - Fax:
Practice Address - Street 1:4600 PARADISE BLVD NW # 66042
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-4106
Practice Address - Country:US
Practice Address - Phone:505-720-3930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSLP-2023-0081235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty