Provider Demographics
NPI:1215653100
Name:WILLIAMS, BRIANNE (BACHELOR OF SCIENCE)
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:BACHELOR OF SCIENCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40722 STATE ROUTE 154
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:OH
Mailing Address - Zip Code:44432-8500
Mailing Address - Country:US
Mailing Address - Phone:330-424-9573
Mailing Address - Fax:
Practice Address - Street 1:40722 STATE ROUTE 154
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:OH
Practice Address - Zip Code:44432-8500
Practice Address - Country:US
Practice Address - Phone:330-424-9573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator