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General NPI Number Information
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NPI Number | 1306429733
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Entity Type | Individual
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Provider Name | MRS. MELINDA WILLIAMSON
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Gender | Female
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Dates
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Enumeration Date | 05/03/2021
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Last Update Date | 05/03/2021
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Provider Practice Location Address
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Address Line | 506 GROVER ST STE 112
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City | LYNDEN
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State | WA
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Zip | 98264-1960
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Country | US
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Telephone | 360-383-8682
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Fax |
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Provider Business Mailing Address
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Address Line | 3046 VERITY CT
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City | ALPINE
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State | CA
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Zip | 91901-2321
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Country | US
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Telephone | 360-509-4809
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 61133637
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License Number State | WA
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