MEDICARE: RITA MICHELLE WILLIAMS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor
4	101YS0200X	School Counselor
5	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1568806321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RITA MICHELLE WILLIAMS

Provider Business Mailing Address
First Line	:	1230 N DETROIT AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74106-4775
Country	:	US
Telephone Number	:	918-585-8086
Fax Number	:

Provider Business Practice Location Address
First Line	:	1230 N DETROIT AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74106-4775
Country	:	US
Telephone Number	:	918-585-8086
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2013
Last Update Date	:	04/24/2013

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Directions to “ RITA MICHELLE WILLIAMS ” Practice Location

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