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Individual

DEBORAH L WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1091 CENTRAL AVE, WABASH, IN 46992-1526
(260) 563-4407
(260) 563-6440
Mailing address
1814 W 500 N, MARION, IN 46952-9107
(765) 662-9971
(765) 651-6563

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34003856A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000004027
MPLAN ID
IN
01
000000183247
ANTHEM PROVIDER ID
IN
01
000000317611
GENCORP PROVIDER ID
IN
01
0007186320
AETNA PROVIDER ID
IN
01
088367428001
GENERAL LISCENCE #
IN
01
IN0017671
TRICARE PROVIDER ID
IN
Enumeration date
01/11/2007
Last updated
07/09/2007
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