Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 34916 | TX |
NPI | 1063661569 |
---|---|
Provider Name | Dr. Kelley Martin Williams |
First Address | Houston, TX 77058 |
Second Address | Houston, TX 77058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2008 |
Last Update Date | 12/06/2017 |