Provider Demographics
NPI:1932421690
Name:WILLIAMS, ASHA BOND (CCCSLP)
Entity type:Individual
Prefix:
First Name:ASHA
Middle Name:BOND
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6125 LUNA DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-4644
Mailing Address - Country:US
Mailing Address - Phone:706-507-1779
Mailing Address - Fax:
Practice Address - Street 1:705 17TH ST
Practice Address - Street 2:SUITE 407
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-3500
Practice Address - Country:US
Practice Address - Phone:706-321-0930
Practice Address - Fax:706-571-0960
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007262235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist