Healthcare Provider Details

I. General information

NPI: 1477783611
Provider Name (Legal Business Name): DEBORAH MICHELLE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 07/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4939 E YALE AVE
FRESNO CA
93727-1523
US

IV. Provider business mailing address

113 E EL DORADO ST
FRESNO CA
93706-1814
US

V. Phone/Fax

Practice location:
  • Phone: 559-443-4850
  • Fax: 559-255-3078
Mailing address:
  • Phone: 559-441-1387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: