Healthcare Provider Details

I. General information

NPI: 1053224311
Provider Name (Legal Business Name): TIAJUANA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 HILLSIDE RD
ABILENE TX
79603-9005
US

IV. Provider business mailing address

933 HILLSIDE RD
ABILENE TX
79603-9005
US

V. Phone/Fax

Practice location:
  • Phone: 325-370-0354
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number63884
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: