Provider Demographics
NPI:1316161607
Name:BABB, WILLIAM DILLARD III (SCHOOL PSYCHOLOGIST)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DILLARD
Last Name:BABB
Suffix:III
Gender:M
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1094 BRAHMA LANE
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-3320
Mailing Address - Country:US
Mailing Address - Phone:928-502-5231
Mailing Address - Fax:928-502-5348
Practice Address - Street 1:1094 BRAHMA LANE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-3320
Practice Address - Country:US
Practice Address - Phone:928-502-5231
Practice Address - Fax:928-502-5348
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ584822Medicaid