Individual
EVELYN WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CLINICAL DIRECTOR
Contact information
Practice address
20348 E WARNER RD, MESA, AZ 85212-9655
(480) 751-7483
(480) 279-3828
Mailing address
20348 E WARNER RD, MESA, AZ 85212-9655
(480) 751-7483
(480) 279-3828
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
—
—
102X00000X
Poetry Therapist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
177F00000X
Lodging Provider
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
438547
—
AZ
Enumeration date
08/25/2008
Last updated
11/09/2009
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