Healthcare Provider Details

I. General information

NPI: 1265561492
Provider Name (Legal Business Name): MARIA B. WILLIAMS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ZUNI PUBLIC SCHOOL DISTRICT 12 TWINBUTTES DR
ZUNI NM
87327
US

IV. Provider business mailing address

2820 UTAH ST NE
ALBUQUERQUE NM
87110-3742
US

V. Phone/Fax

Practice location:
  • Phone: 505-782-5511
  • Fax: 505-782-5870
Mailing address:
  • Phone: 505-238-5059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number000T7568
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: