Provider Demographics
NPI:1285365551
Name:PURCELL, WILLA DENISE
Entity type:Individual
Prefix:
First Name:WILLA
Middle Name:DENISE
Last Name:PURCELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 ROLAND JONES RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-3719
Mailing Address - Country:US
Mailing Address - Phone:828-388-2819
Mailing Address - Fax:
Practice Address - Street 1:464 ROLAND JONES RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-3719
Practice Address - Country:US
Practice Address - Phone:828-388-2819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-18
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician