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General NPI Number Information
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NPI Number | 1770172769
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Entity Type | Individual
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Provider Name | JONATHAN KNOX WILLIAMS MMT, MT-BC
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Gender | Male
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Dates
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Enumeration Date | 01/13/2021
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 1915 E MAIN ST APT D226
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City | RICHMOND
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State | VA
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Zip | 23223-7167
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Country | US
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Telephone | 864-921-7344
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Fax |
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Provider Business Mailing Address
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Address Line | 16620 40TH AVE N
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City | MINNEAPOLIS
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State | MN
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Zip | 55446-2687
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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 | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State |
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