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General NPI Number Information
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NPI Number | 1578061321
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Entity Type | Individual
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Provider Name | FREDERICK WILLIAMS MSW
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Gender | Male
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Dates
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Enumeration Date | 01/26/2018
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Last Update Date | 01/26/2018
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Provider Practice Location Address
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Address Line | 53 MAMMOTH RD
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City | MANCHESTER
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State | NH
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Zip | 03109-4301
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Country | US
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Telephone | 603-622-7851
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Fax |
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Provider Business Mailing Address
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Address Line | 198 MAYNARD AVE
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City | MANCHESTER
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State | NH
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Zip | 03103-3025
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Country | US
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Telephone | 603-785-4544
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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 | 1221
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License Number State | NH
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