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General NPI Number Information
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NPI Number | 1487470720
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Entity Type | Individual
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Provider Name | JOEY LOIS WILLIAMS
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Gender |
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 451 HEALTH PKWY STE E
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City | PAW PAW
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State | MI
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Zip | 49079-8242
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Country | US
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Telephone | 269-655-3063
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Fax |
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Provider Business Mailing Address
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Address Line | 28140 WEXFORD DR
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City | LAWTON
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State | MI
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Zip | 49065-9606
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Country | US
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Telephone | 574-612-3567
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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 | 6851101675
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License Number State | MI
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