Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | P1604051 | AR |
N | 101YP1600X | Pastoral Counselor | P1604051 | AR |
N | 101YP2500X | Professional Counselor | P1604051 | AR |
NPI | 1013376722 |
---|---|
Provider Name | J Dawson Williams |
First Address | Jacksonville, AR 72076-4280 |
Second Address | North Little Rock, AR 72116-8089 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2016 |
Last Update Date | 22/04/2016 |