Doctor Name: | MR. MARC LEE WILLIAMS |
NPI Number: | 1184780207 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 3101 |
Business Practice Address: | 140 Dream Haven Ln Mocksville, NC - 270284869 |
Business Phone Number: | 3364925065 |
Business Fax Number: | |
Mailing Address: | 140 Dream Haven Ln, MOCKSVILLE |
State: | NC |
Postal Code: | 270284869 |
Phone Number: | 3364925065 |
Fax Number: | |
NPI Enumeration Date: | 01/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 3101 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |