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General NPI Number Information
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NPI Number | 1003671561
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Entity Type | Organization
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Legal Business Name | DISABILITIES LIBERATED LLC
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Dates
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Enumeration Date | 02/14/2024
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 128 MARSHALL ST
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City | YELLOW SPRINGS
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State | OH
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Zip | 45387-1618
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Country | US
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Telephone | 937-266-9375
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Fax |
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Provider Business Mailing Address
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Address Line | 128 MARSHALL ST
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City | YELLOW SPRINGS
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State | OH
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Zip | 45387-1618
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Country | US
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Telephone | 937-266-9375
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | JULIE LYNN WILLIAMS
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Credential | PSY.D.
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Telephone | 937-266-9375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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