Provider Demographics
NPI:1104215003
Name:WILLIAMS, WAYNE ALAN (BCBA)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:ALAN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5465 ABLE CT
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-3100
Mailing Address - Country:US
Mailing Address - Phone:251-644-5938
Mailing Address - Fax:251-410-5968
Practice Address - Street 1:5465 ABLE CT
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-3100
Practice Address - Country:US
Practice Address - Phone:251-644-5938
Practice Address - Fax:251-410-5968
Is Sole Proprietor?:No
Enumeration Date:2015-01-15
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2018-081103K00000X
AL1-14-17208103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst