Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 000097 | CT |
NPI | 1073772307 |
---|---|
Provider Name | Dr. Deirdre Ballou Williams |
First Address | Wilton, CT 06897-4524 |
Second Address | Wilton, CT 06897-4524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2008 |
Last Update Date | 02/06/2008 |