MEDICARE: MRS. ALTHEA LORAINE WILLIAMS M.S.W.

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	1041S0200X	School Social Worker

General Provider Information

NPI Number	:	1790097533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALTHEA LORAINE WILLIAMS M.S.W.

Provider Business Mailing Address
First Line	:	7272 W OAKLAND PARK BLVD
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33313-1041
Country	:	US
Telephone Number	:	954-578-8399
Fax Number	:	954-578-0145

Provider Business Practice Location Address
First Line	:	7272 W OAKLAND PARK BLVD
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33313-1041
Country	:	US
Telephone Number	:	954-578-8399
Fax Number	:	954-578-0145

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

Provider Enumeration Date	:	07/09/2010
Last Update Date	:	07/09/2010

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