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General NPI Number Information
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NPI Number | 1043393432
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Entity Type | Individual
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Provider Name | MICHAEL D. WILLIAMS PH.D.
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 10/22/2010
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Provider Practice Location Address
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Address Line | 174 DEAN ST UNIT D
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City | TAUNTON
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State | MA
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Zip | 02780-2782
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Country | US
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Telephone | 508-212-5730
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Fax | 508-337-9338
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Provider Business Mailing Address
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Address Line | 3 SANDY HILL RD
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City | MANSFIELD
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State | MA
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Zip | 02048-3246
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Country | US
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Telephone | 508-212-5730
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Fax | 508-337-9338
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 7469
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 7469
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License Number State | MA
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