Provider Demographics
NPI:1114433570
Name:WILLIAMS, KIRSTEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KIRSTEE
Middle Name:
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 1:1120 NORTH OCOEE STREET
Mailing Address - Street 2:LEE UNIVERSITY
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311
Mailing Address - Country:US
Mailing Address - Phone:423-503-9002
Mailing Address - Fax:
Practice Address - Street 1:1120 NORTH OCOEE STREET
Practice Address - Street 2:LEE UNIVERSITY
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311
Practice Address - Country:US
Practice Address - Phone:423-503-9002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN935101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty