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NPI Code Detail

MEDICARE: DARYL ANDRE WILLIAMS TCADC

MEDICARE: DARYL ANDRE WILLIAMS TCADC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor243223KY

General Provider Information

NPI Number : 1528524097
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARYL ANDRE WILLIAMS TCADC
Provider Business Mailing Address
First Line : 1220 GREENUP AVE
Second Line :
City : ASHLAND
State : KY
Zip : 41101-7525
Country : US
Telephone Number : 606-393-1165
Fax Number : 606-393-1775
Provider Business Practice Location Address
First Line : 1220 GREENUP AVE
Second Line :
City : ASHLAND
State : KY
Zip : 41101-7525
Country : US
Telephone Number : 606-393-1165
Fax Number : 606-393-1775
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2019
Last Update Date : 02/20/2019

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Directions to “ DARYL ANDRE WILLIAMS TCADC” Practice Location

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