Individual
STACY WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4904 GUINEVERE CT, DURHAM, NC 27712-2559
(919) 308-3739
Mailing address
4904 GUINEVERE CT, DURHAM, NC 27712-2559
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
222Q00000X
CBRS
—
Enumeration date
09/28/2017
Last updated
09/28/2017
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