Provider Demographics
NPI:1114140969
Name:TIMMONS, CAROLYN WILLIAMSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:WILLIAMSON
Last Name:TIMMONS
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 1:21 LYNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-7911
Mailing Address - Country:US
Mailing Address - Phone:269-788-2724
Mailing Address - Fax:
Practice Address - Street 1:4625 BECKLEY RD
Practice Address - Street 2:BLDG 100
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-7948
Practice Address - Country:US
Practice Address - Phone:269-788-2724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011444103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist