Individual
SHANNA WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
8495 CRATER LAKE HWY, WHITE CITY, OR 97503-3011
(541) 826-2111
Mailing address
6195 MILLER RD, STE A, SWARTZ CREEK, MI 48473
(810) 630-1152
(810) 630-9107
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301018846
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6301018846
LICENSE NUMBER
MI
Enumeration date
10/24/2012
Last updated
06/16/2022
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