Healthcare Provider Details

I. General information

NPI: 1609318518
Provider Name (Legal Business Name): ALISSA WILLIAMS CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2016
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7597 BRIDGETOWN RD
CINCINNATI OH
45248-2019
US

IV. Provider business mailing address

69 KELLY CT
HAMILTON OH
45013-6024
US

V. Phone/Fax

Practice location:
  • Phone: 513-941-4999
  • Fax: 513-941-7555
Mailing address:
  • Phone: 513-941-4999
  • Fax: 513-941-7555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number151627
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: