Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 5366 | CT |
NPI | 1003254251 |
---|---|
Provider Name | Caitlin R Williams |
First Address | Enfield, CT 06082-4592 |
Second Address | Enfield, CT 06082-4592 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2013 |
Last Update Date | 10/06/2013 |