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NPI Code Detail

MEDICARE: RODELINE WILLIAMS

MEDICARE: RODELINE 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1558981902
Entity Type Code : Individual
Provider Name (Legal Business Name) : RODELINE WILLIAMS
Provider Business Mailing Address
First Line : 3870 W ALAMEDA RD
Second Line :
City : GLENDALE
State : AZ
Zip : 85310-3302
Country : US
Telephone Number : 623-308-7238
Fax Number : 480-304-3153
Provider Business Practice Location Address
First Line : 17235 N 75TH AVE STE F100
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-0871
Country : US
Telephone Number : 480-641-1165
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2020
Last Update Date : 04/24/2020

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Directions to “ RODELINE WILLIAMS ” Practice Location

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