Provider Demographics
NPI:1407308562
Name:WILLIAMS, SHARON
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
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 1:430 BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4921
Mailing Address - Country:US
Mailing Address - Phone:781-654-1698
Mailing Address - Fax:508-830-0474
Practice Address - Street 1:1 S SPOONER ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4446
Practice Address - Country:US
Practice Address - Phone:781-654-1697
Practice Address - Fax:508-830-0474
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator