Provider Demographics
NPI:1316138969
Name:WILLIAMSON, SALLY ANN (LMFT)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:ANN
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 GATEWAY DR STE A
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-6839
Mailing Address - Country:US
Mailing Address - Phone:334-749-1068
Mailing Address - Fax:334-749-8528
Practice Address - Street 1:2108 GATEWAY DR STE A
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-6839
Practice Address - Country:US
Practice Address - Phone:334-749-1068
Practice Address - Fax:334-749-8528
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLMFT 30101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional