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NPI Code Detail

MEDICARE: MRS. CECELIA WILLIS

MEDICARE: MRS. CECELIA WILLIS
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
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1801728142
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CECELIA WILLIS
Provider Business Mailing Address
First Line : 240 S RICHLAND
Second Line :
City : STEPHENS
State : AR
Zip : 71764-8016
Country : US
Telephone Number : 870-260-6419
Fax Number :
Provider Business Practice Location Address
First Line : 301 W CALHOUN
Second Line :
City : MAGNOLIA
State : AR
Zip : 71753-3508
Country : US
Telephone Number : 870-901-3343
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ MRS. CECELIA WILLIS ” Practice Location

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