Individual
IMANI WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2316 DEER SPRINGS DR, ELLENWOOD, GA 30294-1168
(785) 401-0096
Mailing address
4500 SATELLITE BLVD STE 2250, DULUTH, GA 30096-5047
(800) 381-2195
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
GA
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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