Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | B1-0000798 | DE |
Y | 103TC0700X | Clinical Psychologist | B1-0000798 | DE |
NPI | 1003055427 |
---|---|
Provider Name | Dr. Dahra Jackson Williams |
First Address | Hockessin, DE 19707 |
Second Address | Hockessin, DE 19707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2009 |
Last Update Date | 09/02/2009 |