Individual
KATIE JO WILLIAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
102 HOWARD AVE, MULLENS, WV 25882-1419
(304) 294-5353
Mailing address
102 HOWARD AVE, MULLENS, WV 25882-1419
(304) 294-5353
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
435
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005489001
—
WV
Enumeration date
03/26/2020
Last updated
03/26/2020
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