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General NPI Number Information
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NPI Number | 1083149264
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Entity Type | Individual
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Provider Name | KENDRA WILLIAMSON BCBA
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Gender | Female
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Dates
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Enumeration Date | 04/26/2017
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Last Update Date | 04/28/2022
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Provider Practice Location Address
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Address Line | 187 W SCHROCK RD
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City | WESTERVILLE
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State | OH
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Zip | 43081
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Country | US
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Telephone | 614-355-7500
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Fax | 614-355-7533
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Provider Business Mailing Address
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Address Line | DEPT 781625 P.O. BOX 78000
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City | DETROIT
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State | MI
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Zip | 48278-1625
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Country | US
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Telephone | 614-355-8004
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Fax | 614-355-2220
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-22-57680
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License Number State | OH
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