Healthcare Provider Details

I. General information

NPI: 1629454236
Provider Name (Legal Business Name): GRIZEL WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2015
Last Update Date: 11/27/2025
Certification Date: 11/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 W PALISADE DR
MOAB UT
84532-2030
US

IV. Provider business mailing address

705 W PALISADE DR
MOAB UT
84532-2030
US

V. Phone/Fax

Practice location:
  • Phone: 423-557-5535
  • Fax:
Mailing address:
  • Phone: 423-557-5535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number12087636-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: