Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003317280 |
---|---|
Provider Name | Sionie Williams |
First Address | Brockton, MA 02301-4640 |
Second Address | Brockton, MA 02301-4640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2018 |
Last Update Date | 23/02/2018 |