Doctor Name: | TERRI G WILLIAMSON |
NPI Number: | 1144353863 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | MH5405 |
Business Practice Address: | 162 Martesia Way Indian Harbour Beach, FL - 329373569 |
Business Phone Number: | 3219617667 |
Business Fax Number: | 3216325613 |
Mailing Address: | 3270 Suntree Blvd Ste 122, MELBOURNE |
State: | FL |
Postal Code: | 329407540 |
Phone Number: | 3219617667 |
Fax Number: | 3216325613 |
NPI Enumeration Date: | 03/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH5405 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |