Healthcare Provider Details

I. General information

NPI: 1265229314
Provider Name (Legal Business Name): WILLIAM-ALBERT ROBERT WILLIAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: WILLIAM ALBERT WILLIAMS

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 LOUISA ST
LANSING MI
48911-0213
US

IV. Provider business mailing address

2730 E ROBIN DR
SAGINAW MI
48601-9214
US

V. Phone/Fax

Practice location:
  • Phone: 313-497-2665
  • Fax:
Mailing address:
  • Phone: 989-827-8043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: