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General NPI Number Information
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NPI Number | 1235420381
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Entity Type | Individual
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Provider Name | MARY KRISTI WILLIAMS M.A.
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Gender | Female
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Dates
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Enumeration Date | 04/25/2011
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 231 DAVIS ST
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City | BRIDGEPORT
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State | WV
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Zip | 26330-1703
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Country | US
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Telephone | 304-842-0044
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Fax | 304-842-0033
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Provider Business Mailing Address
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Address Line | 1801 HALLECK RD
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City | MORGANTOWN
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State | WV
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Zip | 26508-2389
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Country | US
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Telephone | 304-282-5752
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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 | 772
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License Number State | WV
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