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NPI Code Detail

MEDICARE: MS. LESLIE AMANDA WILLIAMS BS, BHRS, CM, USP

MEDICARE: MS. LESLIE AMANDA WILLIAMS BS, BHRS, CM, USP
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1932439569
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LESLIE AMANDA WILLIAMS BS, BHRS, CM, USP
Provider Business Mailing Address
First Line : 901 W 18TH ST
Second Line :
City : ADA
State : OK
Zip : 74820-7423
Country : US
Telephone Number : 580-436-6130
Fax Number : 580-436-6135
Provider Business Practice Location Address
First Line : 901 W 18TH ST
Second Line :
City : ADA
State : OK
Zip : 74820-7423
Country : US
Telephone Number : 580-436-6130
Fax Number : 580-436-6135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2010
Last Update Date : 01/04/2010

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