Healthcare Provider Details

I. General information

NPI: 1962400093
Provider Name (Legal Business Name): JODY STEELE WILLIAMS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date: 03/16/2006
Reactivation Date: 03/29/2006

III. Provider practice location address

884 WALKER RD SUITE 5C
DOVER DE
19904-2758
US

IV. Provider business mailing address

884 WALKER RD SUITE 5C
DOVER DE
19904-2758
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-2199
  • Fax: 302-734-7780
Mailing address:
  • Phone: 302-674-2199
  • Fax: 302-734-7780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberB1-0000647
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: