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General NPI Number Information
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NPI Number | 1396108122
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Entity Type | Individual
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Provider Name | INEZ WILLIAMSON C.A.R.F
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Gender | Female
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Dates
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Enumeration Date | 03/30/2016
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 13349 HIGHWAY 742 N
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City | POLKTON
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State | NC
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Zip | 28135-7727
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Country | US
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Telephone | 704-690-0152
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Fax | 704-826-8737
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Provider Business Mailing Address
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Address Line | 3300 CAPPADOCIA CHURCH RD
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City | POLKTON
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State | NC
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Zip | 28135-9259
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Country | US
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Telephone | 704-690-0152
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Fax | 704-594-4336
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 80923
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 80923
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License Number State | NC
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