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General NPI Number Information
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NPI Number | 1477090884
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Entity Type | Individual
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Provider Name | KALENE WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 01/23/2017
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Last Update Date | 01/23/2017
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Provider Practice Location Address
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Address Line | 8282 28TH CT NE SUITE A
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City | LACEY
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State | WA
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Zip | 98516-7162
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Country | US
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Telephone | 360-915-6868
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Fax |
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Provider Business Mailing Address
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Address Line | 16740 PORT ORFORD BLVD SE
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City | YELM
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State | WA
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Zip | 98597-9728
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Country | US
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Telephone | 253-306-3706
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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