Healthcare Provider Details

I. General information

NPI: 1205250123
Provider Name (Legal Business Name): ALICIA WILLIAMS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2014
Last Update Date: 02/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 N 28TH WEST AVE
TULSA OK
74127-6139
US

IV. Provider business mailing address

551 N 28TH WEST AVE
TULSA OK
74127-6139
US

V. Phone/Fax

Practice location:
  • Phone: 918-794-0197
  • Fax: 918-794-0196
Mailing address:
  • Phone: 918-794-0197
  • Fax: 918-794-0196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: