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Individual

DANIELLE WILLIAMS-OMORUYI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1030 JEFFERSON AVE, MEMPHIS, TN 38104-2127
(901) 523-8990
Mailing address
3933 RASCO HILLS DR, SOUTHAVEN, MS 38671-6403

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6818
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3435
HAVE NOT RECEIVED MEDICAID NUMBER AS OF YET
Enumeration date
01/22/2020
Last updated
01/16/2025
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