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General NPI Number Information
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NPI Number | 1205086188
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Entity Type | Individual
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Provider Name | KELLI SUE WILLIAMS PHD
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Gender | Female
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Dates
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Enumeration Date | 09/26/2008
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Last Update Date | 01/29/2013
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Provider Practice Location Address
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Address Line | 1800 LOMBARD ST GROUND FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19146-1414
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Country | US
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Telephone | 215-662-3259
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Fax | 215-615-3610
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Provider Business Mailing Address
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Address Line | 1800 LOMBARD ST GROUND FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19146-1414
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Country | US
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Telephone | 215-662-3259
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS006186L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number | PS006186L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | PS006186L
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License Number State | PA
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