MEDICARE: MS. JANET L. WILLIAMS C.G.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170300000X	Genetic Counselor (M.S.)	57657163601	UT

General Provider Information

NPI Number	:	1023092772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANET L. WILLIAMS C.G.C.

Provider Business Mailing Address
First Line	:	324 10TH AVE
Second Line	:	SUITE 130
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84103-2853
Country	:	US
Telephone Number	:	801-408-5057
Fax Number	:	801-408-2361

Provider Business Practice Location Address
First Line	:	324 10TH AVE
Second Line	:	SUITE 130
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84103-2853
Country	:	US
Telephone Number	:	801-408-5057
Fax Number	:	801-408-2361

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	07/08/2007

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