Individual
KEISA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 FAIRLANE DR, CONKLIN, NY 13748-1239
(607) 727-9240
Mailing address
12 FAIRLANE DR, CONKLIN, NY 13748-1239
(607) 727-9240
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
799099
NY
Other
Enumeration date
04/14/2023
Last updated
04/14/2023
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