Provider Demographics
NPI:1043412778
Name:WILLIAMS, MARK ZACHARY
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:ZACHARY
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 WINDSOR TRCE
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-2129
Mailing Address - Country:US
Mailing Address - Phone:931-797-5184
Mailing Address - Fax:
Practice Address - Street 1:115 DYER ST
Practice Address - Street 2:SUITE 1
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4551
Practice Address - Country:US
Practice Address - Phone:931-560-4220
Practice Address - Fax:931-560-4221
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor