MEDICARE: HANNAH MAE ELIZABETH 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
1	106S00000X	Behavior Technician	RBT-23-255836	SD

General Provider Information

NPI Number	:	1598462913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH MAE ELIZABETH WILLIAMS

Provider Business Mailing Address
First Line	:	59 DOWEY CT
Second Line	:
City	:	ELGIN
State	:	SC
Zip	:	29045-9227
Country	:	US
Telephone Number	:	803-420-6468
Fax Number	:

Provider Business Practice Location Address
First Line	:	1710 BROAD ST
Second Line	:
City	:	CAMDEN
State	:	SC
Zip	:	29020-2602
Country	:	US
Telephone Number	:	803-420-6468
Fax Number	:

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

Provider Enumeration Date	:	02/15/2023
Last Update Date	:	02/15/2023

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