Healthcare Provider Details

I. General information

NPI: 1558947416
Provider Name (Legal Business Name): CHERYL S WILLIAMS DOCTOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3620 N RANCHO DR STE 106
LAS VEGAS NV
89130-3153
US

IV. Provider business mailing address

PO BOX 336065
NORTH LAS VEGAS NV
89033-6065
US

V. Phone/Fax

Practice location:
  • Phone: 702-969-5933
  • Fax:
Mailing address:
  • Phone: 702-969-5933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: