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NPI Code Detail

MEDICARE: MELISSA ANN WILLIAMS

MEDICARE: MELISSA ANN WILLIAMS
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
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1346864519
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA ANN WILLIAMS
Provider Business Mailing Address
First Line : 3047 FLINTLOCK DR
Second Line :
City : PENSACOLA
State : FL
Zip : 32526-8065
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8418 E BAY BLVD
Second Line :
City : NAVARRE
State : FL
Zip : 32566-6306
Country : US
Telephone Number : 850-307-8811
Fax Number : 850-939-7879
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2020
Last Update Date : 07/10/2020

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