Provider Demographics
NPI:1356019384
Name:WILLIAMS, DONAVAN JUVAR
Entity Type:Individual
Prefix:
First Name:DONAVAN
Middle Name:JUVAR
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 N RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48609-6832
Mailing Address - Country:US
Mailing Address - Phone:989-596-3557
Mailing Address - Fax:
Practice Address - Street 1:925 N RIVER RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48609-6831
Practice Address - Country:US
Practice Address - Phone:989-781-2780
Practice Address - Fax:989-781-7152
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)