Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1144785239 |
---|---|
Provider Name | Katisha Williams |
First Address | Columbus, GA 31901-2248 |
Second Address | Columbus, GA 31901-2248 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2019 |
Last Update Date | 04/02/2019 |