Provider Demographics
NPI:1003055427
Name:WILLIAMS, DAHRA JACKSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAHRA
Middle Name:JACKSON
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 YORKLYN ROAD
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707
Mailing Address - Country:US
Mailing Address - Phone:302-238-5255
Mailing Address - Fax:302-239-5531
Practice Address - Street 1:710 YORKLYN ROAD
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707
Practice Address - Country:US
Practice Address - Phone:302-238-5255
Practice Address - Fax:302-239-5531
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000798103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical