Healthcare Provider Details
I. General information
NPI: 1194429605
Provider Name (Legal Business Name): KAREN LYNN WILLIAMS MS, ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/28/2023
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
703 PORTER AVE APT 410
MARTINSBURG WV
25401-1822
US
IV. Provider business mailing address
110 MAIN ST
BECKLEY WV
25801-4611
US
V. Phone/Fax
- Phone: 202-792-4107
- Fax:
- Phone: 202-792-4107
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | WV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: