MEDICARE: KRIS WILLIAMS BA

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1689785941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRIS WILLIAMS BA

Provider Business Mailing Address
First Line	:	1418 NW 44TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-5002
Country	:	US
Telephone Number	:	405-315-9901
Fax Number	:

Provider Business Practice Location Address
First Line	:	1418 NW 44TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-5002
Country	:	US
Telephone Number	:	405-315-9901
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	10/15/2008

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Directions to “ KRIS WILLIAMS BA” Practice Location

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