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General NPI Number Information
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NPI Number | 1689485872
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Entity Type | Individual
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Provider Name | SUZANNE WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 14480 CRAIG LN
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City | GRASS VALLEY
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State | CA
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Zip | 95945-8477
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Country | US
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Telephone | 630-750-0936
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22
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City | NEVADA CITY
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State | CA
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Zip | 95959-0022
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Country | US
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Telephone |
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | A-3978505
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License Number State | CA
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