Provider Demographics
NPI:1578693743
Name:WILLIAMS, KAMELIA M (SLP)
Entity type:Individual
Prefix:
First Name:KAMELIA
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 RAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-1154
Mailing Address - Country:US
Mailing Address - Phone:405-760-7801
Mailing Address - Fax:405-760-7801
Practice Address - Street 1:2929 W HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1534
Practice Address - Country:US
Practice Address - Phone:610-991-2034
Practice Address - Fax:610-438-2046
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101659235Z00000X
OK5147235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00936XMedicare ID - Type UnspecifiedPART B GROUP NUMBER
TX676600Medicare Oscar/Certification
TX676559Medicare Oscar/Certification
TX676626Medicare Oscar/Certification
TX676554Medicare Oscar/Certification
TX676555Medicare Oscar/Certification
TX676564Medicare Oscar/Certification