Provider Demographics
NPI:1295019370
Name:WILLIAMS, JESSICA JOYCE
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:JOYCE
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 1:4408 N REDMOND AVE
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-2845
Mailing Address - Country:US
Mailing Address - Phone:405-248-7105
Mailing Address - Fax:
Practice Address - Street 1:3838 NW 36TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2970
Practice Address - Country:US
Practice Address - Phone:405-248-7105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor