Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PS-008219-L | PA |
Y | 103T00000X | Psychologist | PS-008219-L | PA |
N | 103TC1900X | Counseling Psychologist | PA-008219-L | PA |
NPI | 1003814930 |
---|---|
Provider Name | Dr. R Jane Williams |
First Address | Bethlehem, PA 18020-6452 |
Second Address | Bethelehem, PA 18018-6614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 10/09/2016 |