Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013291939 |
---|---|
Provider Name | Tmothy Williamson |
First Address | Edmond, OK 73013-2810 |
Second Address | Oklahoma City, OK 73106-7220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2011 |
Last Update Date | 11/10/2011 |