Provider Demographics
NPI:1285762104
Name:WILLIAMS, RICKI HEAD (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:RICKI
Middle Name:HEAD
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2755 OAKHURST DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-9064
Mailing Address - Country:US
Mailing Address - Phone:803-366-4662
Mailing Address - Fax:
Practice Address - Street 1:2755 OAKHURST DR
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-9064
Practice Address - Country:US
Practice Address - Phone:803-366-4662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4001235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist