Healthcare Provider Details

I. General information

NPI: 1952266074
Provider Name (Legal Business Name): KATRICE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2206 N KICKAPOO AVE
SHAWNEE OK
74804-2703
US

IV. Provider business mailing address

2206 N KICKAPOO AVE
SHAWNEE OK
74804-2703
US

V. Phone/Fax

Practice location:
  • Phone: 405-283-6355
  • Fax:
Mailing address:
  • Phone: 405-283-6355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: