Provider Demographics
NPI:1073295804
Name:WILLIAMS, PAYTON FAITH
Entity Type:Individual
Prefix:
First Name:PAYTON
Middle Name:FAITH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 MAPLECREST CIR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7806
Mailing Address - Country:US
Mailing Address - Phone:423-794-7230
Mailing Address - Fax:
Practice Address - Street 1:19044 SE ARNOLD DR
Practice Address - Street 2:
Practice Address - City:TEQUESTA
Practice Address - State:FL
Practice Address - Zip Code:33469-1681
Practice Address - Country:US
Practice Address - Phone:561-316-7260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician