Individual
WILLIAM WITHERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 FRANDORSON CIR, SUITE 103, APOLLO BEACH, FL 33572-2688
(813) 641-3565
(813) 640-3560
Mailing address
400 FRANDORSON CIR, SUITE 103, APOLLO BEACH, FL 33572-2688
(813) 641-3565
(813) 640-3560
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
IMH3516
FL
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
766864300
—
FL
Enumeration date
08/10/2010
Last updated
08/10/2010
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