MEDICARE: DELISHIA 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
1	1041C0700X	Clinical Social Worker	073082	IA

General Provider Information

NPI Number	:	1871901116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELISHIA WILLIAMS

Provider Business Mailing Address
First Line	:	8350 EP TRUE PKWY UNIT 2301
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-8344
Country	:	US
Telephone Number	:	202-446-8250
Fax Number	:

Provider Business Practice Location Address
First Line	:	8350 EP TRUE PKWY UNIT 2301
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-8344
Country	:	US
Telephone Number	:	202-446-8250
Fax Number	:

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

Provider Enumeration Date	:	07/31/2014
Last Update Date	:	07/31/2014

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