Provider Demographics
NPI:1417293366
Name:WILLIAMS, JENNIFER E (EDD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:791 E MCMILLAN ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-1910
Mailing Address - Country:US
Mailing Address - Phone:513-312-2341
Mailing Address - Fax:513-542-6646
Practice Address - Street 1:791 E MCMILLAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1910
Practice Address - Country:US
Practice Address - Phone:513-312-2341
Practice Address - Fax:513-542-6646
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-21
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.006066-CR101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional