| NPI | 1609305549 | 
|---|---|
| Former Name | PHYLICIA WILLIAMS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 8399)  | 
| Additional Taxonomies | 106S00000X Behavior Technician | 
| Enumeration Date | 2017-06-05 | 
| Last Update Date | 2023-10-17 |