Provider Demographics
NPI:1164943437
Name:WILLIAMS, ANGELA J
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:J
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 1:116 MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-3626
Mailing Address - Country:US
Mailing Address - Phone:434-843-5070
Mailing Address - Fax:434-843-5071
Practice Address - Street 1:116 MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-3626
Practice Address - Country:US
Practice Address - Phone:434-843-5070
Practice Address - Fax:434-843-5071
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2717-03-001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health