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General NPI Number Information
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NPI Number | 1124315064
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Entity Type | Individual
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Provider Name | ANGIE MARIE WILLIAMSON MS, LPCC, RDN, LDN
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Gender | Female
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 610 W 1ST AVE
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City | OSAKIS
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State | MN
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Zip | 56360-8227
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Country | US
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Telephone | 952-484-0841
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 120
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City | OSAKIS
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State | MN
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Zip | 56360-0120
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Country | US
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Telephone | 320-766-6333
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Fax |
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 886167
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CC02695
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License Number State | MN
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