Provider Demographics
NPI:1063774438
Name:WILLIAMS, TIHIRA JANAIR (SPECIAL EDTEACHER)
Entity type:Individual
Prefix:MISS
First Name:TIHIRA
Middle Name:JANAIR
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:SPECIAL EDTEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214-14 HILLSIDE AVE 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427
Mailing Address - Country:US
Mailing Address - Phone:347-435-8580
Mailing Address - Fax:
Practice Address - Street 1:97-77 QUEENS BLVD
Practice Address - Street 2:PENTHOUSE
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-830-9274
Practice Address - Fax:718-830-0761
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY409323252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency