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NPI Code Detail

MEDICARE: MARY ANN WILLIAMS PHD

MEDICARE:   MARY ANN WILLIAMS  PHD
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 CounselorIMH 6263FL

General Provider Information

NPI Number : 1720318801
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY ANN WILLIAMS PHD
Provider Business Mailing Address
First Line : 2630 NW 41ST STREET
Second Line : D-3
City : GAINESVILLE
State : FL
Zip : 32606
Country : US
Telephone Number : 352-375-2578
Fax Number : 352-375-2555
Provider Business Practice Location Address
First Line : 2630 NW 41ST ST
Second Line : D-3
City : GAINESVILLE
State : FL
Zip : 32606-7495
Country : US
Telephone Number : 352-375-2578
Fax Number : 352-375-2555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2010
Last Update Date : 01/12/2010

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