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NPI Code Detail

MEDICARE: BRIAN WILLIAMS

MEDICARE: BRIAN WILLIAMS
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1437818762
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN WILLIAMS
Provider Business Mailing Address
First Line : 5963 KENTSHIRE DR
Second Line :
City : DAYTON
State : OH
Zip : 45440-4253
Country : US
Telephone Number : 937-952-6379
Fax Number :
Provider Business Practice Location Address
First Line : 5963 KENTSHIRE DR
Second Line :
City : DAYTON
State : OH
Zip : 45440-4253
Country : US
Telephone Number : 937-952-6379
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2021
Last Update Date : 12/14/2021

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Directions to “ BRIAN WILLIAMS ” Practice Location

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