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General NPI Number Information
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NPI Number | 1205275633
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Entity Type | Individual
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Provider Name | RENISEYA DELIAH WILLIAMS LLP
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Gender | Female
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Dates
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Enumeration Date | 06/19/2013
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Last Update Date | 08/05/2022
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Provider Practice Location Address
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Address Line | 20997 SHERMAN AVE
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City | SOUTHFIELD
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State | MI
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Zip | 48033-6662
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Country | US
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Telephone | 313-502-0796
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Fax |
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Provider Business Mailing Address
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Address Line | 28501 FRANKLIN RD APT 338
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1637
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Country | US
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Telephone | 313-502-0796
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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 | 6361003420
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License Number State | MI
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