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General NPI Number Information
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NPI Number | 1326702895
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Entity Type | Individual
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Provider Name | THELMA WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 10/29/2021
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Last Update Date | 10/29/2021
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Provider Practice Location Address
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Address Line | 453 WOODLAND DR
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City | FAIRBURN
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State | GA
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Zip | 30213-1041
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Country | US
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Telephone | 770-256-0168
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Fax |
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Provider Business Mailing Address
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Address Line | 4311 15TH AVE S STE 431115
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City | FARGO
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State | ND
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Zip | 58103-3382
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Country | US
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Telephone | 701-989-2464
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | ND
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