Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 396183 | NY |
NPI | 1013305630 |
---|---|
Provider Name | Dr. Jahzia Andre Williams |
First Address | Brooklyn, NY 11216-5376 |
Second Address | Brooklyn, NY 11216-5376 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2015 |
Last Update Date | 05/01/2015 |