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General NPI Number Information
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NPI Number | 1326058801
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Entity Type | Individual
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Provider Name | JIM WILLIAMS
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Gender | Male
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 07/16/2007
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Provider Practice Location Address
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Address Line | 820 S BOYLAN AVE
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City | RALEIGH
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State | NC
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Zip | 27603
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Country | US
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Telephone | 919-733-5540
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Fax |
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Provider Business Mailing Address
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Address Line | 3601 MSC CTR
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City | RALEIGH
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State | NC
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Zip | 27699-3601
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Country | US
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Telephone |
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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 |
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License Number State |
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