| 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 |