Provider Demographics
NPI:1972622470
Name:WILLIAMS, KATRINA REMONIA
Entity type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:REMONIA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KATRINA
Other - Middle Name:REMONIA
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:224 TITLING ROCK DR.
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:SC
Mailing Address - Zip Code:29061
Mailing Address - Country:US
Mailing Address - Phone:803-629-4389
Mailing Address - Fax:
Practice Address - Street 1:224 TILTING ROCK DR
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:SC
Practice Address - Zip Code:29061-8573
Practice Address - Country:US
Practice Address - Phone:803-629-4389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4614101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional