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General NPI Number Information
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NPI Number | 1992365738
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Entity Type | Individual
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Provider Name | MATTIE WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 06/14/2019
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 110 TRADERS CROSS
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City | BLUFFTON
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State | SC
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Zip | 29909-4637
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Country | US
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Telephone | 843-705-8022
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Fax |
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Provider Business Mailing Address
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Address Line | 20 COLONY GARDENS RD APT 511
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City | BEAUFORT
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State | SC
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Zip | 29907-1263
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Country | US
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Telephone | 436-250-0678
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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 | 12958
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License Number State | SC
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