| Doctor Name: | WILLIAM WITHERS |
| NPI Number: | 1205141710 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | IMH3516 |
| Business Practice Address: | 400 Frandorson Cir Suite 103 Apollo Beach, FL - 335722688 |
| Business Phone Number: | 8136413565 |
| Business Fax Number: | 8136403560 |
| Mailing Address: | 400 Frandorson Cir, Suite 103 APOLLO BEACH |
| State: | FL |
| Postal Code: | 335722688 |
| Phone Number: | 8136413565 |
| Fax Number: | 8136403560 |
| NPI Enumeration Date: | 08/10/2010 |
| NPI Last Update Date: | 08/10/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | IMH3516 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |