Doctor Name: | MR. LYLBURN CLINTON WILLIAMS |
NPI Number: | 1255637112 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 63759 |
Business Practice Address: | 702 San Pedro Ave None San Antonio, TX - 782124610 |
Business Phone Number: | 2105634938 |
Business Fax Number: | 2102992413 |
Mailing Address: | 702 San Pedro Ave, None SAN ANTONIO |
State: | TX |
Postal Code: | 782124610 |
Phone Number: | 2102992400 |
Fax Number: | 2102992413 |
NPI Enumeration Date: | 02/09/2011 |
NPI Last Update Date: | 03/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 63759 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |