Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 150.106571 | IL |
NPI | 1003395088 |
---|---|
Provider Name | Tatjana N Williams |
First Address | Dekalb, IL 60115-9637 |
Second Address | Dekalb, IL 60115-9637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2018 |
Last Update Date | 20/01/2022 |