Provider Demographics
NPI:1164589883
Name:WILLIAMS, BRONWEN ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRONWEN
Middle Name:ELIZABETH
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 1:8 HEARTHSTONE CT
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2644
Mailing Address - Country:US
Mailing Address - Phone:301-977-7782
Mailing Address - Fax:301-977-8287
Practice Address - Street 1:16220 S FREDERICK AVE STE 512
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-4022
Practice Address - Country:US
Practice Address - Phone:301-977-7782
Practice Address - Fax:301-977-8287
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2764103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD35230001OtherCAREFIRST BLUE CROSS
MD038446Medicare ID - Type UnspecifiedMEDICARE NUMBER