Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1013365329 |
---|---|
Provider Name | Evans Dewayne Williams |
First Address | Blenheim, SC 29516-0144 |
Second Address | Blenheim, SC 29516-0144 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2016 |
Last Update Date | 26/05/2016 |