Individual
MS. CONNIE S WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-SUPV
Contact information
Practice address
302 W MAIN ST, FAIRBORN, OH 45324-5037
(937) 281-4673
(937) 318-1120
Mailing address
3103 DIXIE HWY, HAMILTON, OH 45015-1653
(513) 892-4673
(513) 737-1107
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.0800334-SUPV
OH
1041C0700X
Clinical Social Worker
LSW S 0005246
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2272231
—
OH
Enumeration date
11/18/2005
Last updated
10/05/2021
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