Provider Demographics
NPI:1356637219
Name:WILLIAMS, SANDI MARIE
Entity Type:Individual
Prefix:
First Name:SANDI
Middle Name:MARIE
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 1:10702 N 5250 W
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84003-8886
Mailing Address - Country:US
Mailing Address - Phone:801-756-2817
Mailing Address - Fax:
Practice Address - Street 1:1358 W BUSINESS PARK DR
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-2203
Practice Address - Country:US
Practice Address - Phone:801-717-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist