Doctor Name: | RON WILLIAMS |
NPI Number: | 1154451433 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA,CAC I |
License Number: | 1-02610 |
Business Practice Address: | 26184 Outer Dr Lincoln Park, MI - 481462084 |
Business Phone Number: | 3133897528 |
Business Fax Number: | |
Mailing Address: | 49145 Peninsular Dr, BELLEVILLE |
State: | MI |
Postal Code: | 481114977 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/06/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 1-02610 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |