Individual
STACEY E WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2801 MONTECITO DR, DENTON, TX 76205-8510
(479) 236-7854
Mailing address
2801 MONTECITO DR, DENTON, TX 76205-8510
(479) 236-7854
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
628062700
U.S. DEPARTMENT OF LABOR
—
Enumeration date
11/24/2018
Last updated
11/24/2018
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