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NPI Code Detail

MEDICARE: JESSICA WILLIAMSON

MEDICARE: JESSICA WILLIAMSON
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
11041C0700XClinical Social WorkerISW19120FL

General Provider Information

NPI Number : 1194484105
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA WILLIAMSON
Provider Business Mailing Address
First Line : 3870 NIGHTHAWK DR
Second Line :
City : PALM HARBOR
State : FL
Zip : 34684-4133
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3870 NIGHTHAWK DR
Second Line :
City : PALM HARBOR
State : FL
Zip : 34684-4133
Country : US
Telephone Number : 727-215-5879
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2021
Last Update Date : 12/17/2021

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Directions to “ JESSICA WILLIAMSON ” Practice Location

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