| NPI | 1871195040 |
|---|---|
| Doing Business As | PRIVATE PRACTICE |
| Entity Type | Organization |
| Authorized Contact | JAMES DASHUAN WILLIAMS Clinical Director 551-225-1527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-11-12 |
| Last Update Date | 2024-08-21 |