Individual
CYSHELLE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QPBS
Contact information
Practice address
4604 PINE NEEDLE CT, FAYETTEVILLE, NC 28314-2463
(910) 691-7843
Mailing address
4604 PINE NEEDLE CT, FAYETTEVILLE, NC 28314-2463
(910) 691-7843
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-026-901
NC
Other
Enumeration date
09/09/2010
Last updated
09/09/2010
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