Provider Demographics
NPI:1104651272
Name:WILLIAMS, TIMI SAVANNAH (MSBS, MAADCII, MFTS)
Entity type:Individual
Prefix:MRS
First Name:TIMI
Middle Name:SAVANNAH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSBS, MAADCII, MFTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 KNOB HILL DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-1263
Mailing Address - Country:US
Mailing Address - Phone:417-658-5731
Mailing Address - Fax:
Practice Address - Street 1:1570 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-4149
Practice Address - Country:US
Practice Address - Phone:636-204-8051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024027358106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty