Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | PY7038 | FL |
NPI | 1245242049 |
---|---|
Provider Name | Ellen Williams |
First Address | Jacksonville, FL 32216-4317 |
Second Address | Jacksonville, FL 32216-4317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 16/09/2014 |