MEDICARE: MS. DARILYN TAJREE WILLIAMS MSW

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1497266134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DARILYN TAJREE WILLIAMS MSW

Provider Business Mailing Address
First Line	:	5104 REAGAN DR STE 5
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28206-1392
Country	:	US
Telephone Number	:	704-596-0507
Fax Number	:

Provider Business Practice Location Address
First Line	:	5104 REAGAN DR STE 5
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28206-1392
Country	:	US
Telephone Number	:	704-596-0507
Fax Number	:

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

Provider Enumeration Date	:	10/21/2017
Last Update Date	:	10/21/2017

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