Healthcare Provider Details

I. General information

NPI: 1255242236
Provider Name (Legal Business Name): ELLA DIANE WILLIAMS RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 13TH ST STE D
COLUMBUS GA
31901-2246
US

IV. Provider business mailing address

6020 N POINTE DR
COLUMBUS GA
31909-3890
US

V. Phone/Fax

Practice location:
  • Phone: 888-963-2228
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2849740
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: