Healthcare Provider Details

I. General information

NPI: 1346187614
Provider Name (Legal Business Name): STEPHANIE MARIE WILLIAMS CPRS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 DUNMORE DR
DAYTON OH
45459-1130
US

IV. Provider business mailing address

5353 DUNMORE DR
DAYTON OH
45459-1130
US

V. Phone/Fax

Practice location:
  • Phone: 937-715-7136
  • Fax:
Mailing address:
  • Phone: 937-715-7136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberAPS.007213
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: