Provider Demographics
NPI:1841643913
Name:WILLIAMS, DEBRA (BS)
Entity type:Individual
Prefix:MISS
First Name:DEBRA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210 FISHING BRG
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-3724
Mailing Address - Country:US
Mailing Address - Phone:307-630-0503
Mailing Address - Fax:
Practice Address - Street 1:5210 FISHING BRG
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-3724
Practice Address - Country:US
Practice Address - Phone:307-630-0503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-13
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No251B00000XAgenciesCase Management
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program