Individual
TABATHA E WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
2052 INDEPENDENCE DR, NEW WINDSOR, NY 12553
(917) 804-3564
Mailing address
2052 INDEPENDENCE DR, NEW WINDSOR, NY 12553
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174400000X
—
NY
05
—
17440000X
—
NY
05
—
252Y00000X
—
NY
Enumeration date
06/29/2012
Last updated
06/29/2012
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