Individual
MICHELLE A WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC/LBSW
Contact information
Practice address
US HIGHWAY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6401
(505) 368-6431
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6401
(505) 368-6431
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
PENDING
NM
104100000X
Social Worker
X-05605
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NM
Enumeration date
10/23/2006
Last updated
11/05/2008
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