Provider Demographics
NPI:1588325872
Name:WILLIAMS, TAMARA LYNN
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:LYNN
Last Name:WILLIAMS
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 1:163 FRIENDLY DR APT A
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23605-1246
Mailing Address - Country:US
Mailing Address - Phone:908-809-5468
Mailing Address - Fax:
Practice Address - Street 1:610 THIMBLE SHOALS BLVD STE 403
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2573
Practice Address - Country:US
Practice Address - Phone:757-782-2042
Practice Address - Fax:757-506-0432
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical