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General NPI Number Information
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NPI Number | 1134247208
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Entity Type | Organization
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Legal Business Name | SANDRA L WILLIAMS
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | 2229 HWY 25B NORTH
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City | HEBER SPRINGS
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State | AR
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Zip | 72543
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Country | US
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Telephone | 501-250-0000
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Fax | 501-362-0915
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Provider Business Mailing Address
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Address Line | 2237 HIGHWAY 25B
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City | HEBER SPRINGS
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State | AR
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Zip | 72543-6406
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Country | US
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Telephone | 501-250-0000
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Fax | 501-362-0915
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SANDRA LYNN WILLIAMS
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Credential | LCSW
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Telephone | 501-250-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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