Provider Demographics
NPI:1104104157
Name:WILLIAMS, REBECCA ALYNE (MHR, CM)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:ALYNE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MHR, CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3712 GREENWAY TER
Mailing Address - Street 2:
Mailing Address - City:DEL CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73115-2720
Mailing Address - Country:US
Mailing Address - Phone:405-642-6784
Mailing Address - Fax:
Practice Address - Street 1:3712 GREENWAY TER
Practice Address - Street 2:
Practice Address - City:DEL CITY
Practice Address - State:OK
Practice Address - Zip Code:73115-2720
Practice Address - Country:US
Practice Address - Phone:405-642-6784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator