Individual
STACY J WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC I, CRM
Contact information
Practice address
525 FERRY ST SE STE 203, SALEM, OR 97301-3743
(503) 363-0833
(503) 363-0833
Mailing address
3020 BRENNA AVE NE, SALEM, OR 97301-8056
(971) 218-2763
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18-P-02
OR
Other
Enumeration date
05/28/2018
Last updated
05/28/2018
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