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NPI Code Detail

MEDICARE: AYANNA WILLIAMS LICDC

MEDICARE: AYANNA WILLIAMS LICDC
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) Counselor161343OH

General Provider Information

NPI Number : 1629518493
Entity Type Code : Individual
Provider Name (Legal Business Name) : AYANNA WILLIAMS LICDC
Provider Business Mailing Address
First Line : 1520 GERMANTOWN ST
Second Line :
City : DAYTON
State : OH
Zip : 45417-3318
Country : US
Telephone Number : 937-716-1707
Fax Number :
Provider Business Practice Location Address
First Line : 1520 GERMANTOWN ST
Second Line :
City : DAYTON
State : OH
Zip : 45417-3318
Country : US
Telephone Number : 937-716-1707
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2017
Last Update Date : 02/27/2017

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Directions to “ AYANNA WILLIAMS LICDC” Practice Location

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