Doctor Name: | EVANS DEWAYNE WILLIAMS |
NPI Number: | 1013365329 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 201 Elizabeth Street Blenheim, SC - 295160144 |
Business Phone Number: | 8034672338 |
Business Fax Number: | |
Mailing Address: | Po Box 144, BLENHEIM |
State: | SC |
Postal Code: | 295160144 |
Phone Number: | 8034672338 |
Fax Number: | |
NPI Enumeration Date: | 05/26/2016 |
NPI Last Update Date: | 05/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YS0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | School |
Taxonomy Definition: |