Individual
MR. DORAN RAY WILLIAMS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
750 NORTH 200 WEST, PROVO, UT 84601
(801) 373-4760
(801) 373-0639
Mailing address
750 NORTH 200 WEST, PROVO, UT 84601
(801) 373-4760
(801) 373-0639
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1376313501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13763135001001
BLUE CROSS BLUE SHIELD
UT
Enumeration date
04/27/2006
Last updated
07/08/2007
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