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NPI Code Detail

MEDICARE: DR. CRYSTAL L WILLIAMS PSYD

MEDICARE: DR. CRYSTAL L WILLIAMS PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist

General Provider Information

NPI Number : 1164679270
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CRYSTAL L WILLIAMS PSYD
Provider Business Mailing Address
First Line : 4600 MCAULEY PL
Second Line : ML 05047
City : BLUE ASH
State : OH
Zip : 45242-4733
Country : US
Telephone Number : 513-981-4684
Fax Number :
Provider Business Practice Location Address
First Line : 4130 DRY RIDGE RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45252-1914
Country : US
Telephone Number : 513-981-5168
Fax Number : 513-923-5522
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2008
Last Update Date : 11/04/2014

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