Provider Demographics
NPI:1174862940
Name:WILLIAMS, MELISSA D (MFT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:D
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3316 SE 16TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-4401
Mailing Address - Country:US
Mailing Address - Phone:239-233-4040
Mailing Address - Fax:
Practice Address - Street 1:3316 SE 16TH PL
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-4401
Practice Address - Country:US
Practice Address - Phone:239-233-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist