Individual
MARY TODD WILLIAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3217 S PROVIDENCE RD, COLUMBIA, MO 65203-3639
(573) 884-7733
(573) 884-5559
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY01775
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498143601
—
MO
01
—
680007308
RR MEDICARE
MO
01
—
P00415787
RAILROAD MEDICARE
MO
Enumeration date
05/18/2006
Last updated
09/25/2008
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