Healthcare Provider Details

I. General information

NPI: 1639644719
Provider Name (Legal Business Name): SARAH A WILLIAMS EDS.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2018
Last Update Date: 12/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 GADSDEN ST
COLUMBIA SC
29201-6400
US

IV. Provider business mailing address

304 RAPIDS CT
COLUMBIA SC
29212-3037
US

V. Phone/Fax

Practice location:
  • Phone: 803-254-9767
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7023
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: