Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YP1600X | Pastoral Counselor |
NPI | 1073637534 |
---|---|
Provider Name | Ronald Keith Williams-Garcia |
First Address | Felton, DE 19943 |
Second Address | Felton, DE 19943 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 15/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1073637534 | (05) | DE |