Provider Demographics
NPI:1457497661
Name:WILLIAMS, RONDA L (SA COUNSELOR - LADC)
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:SA COUNSELOR - LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:PERTH ANDOVER
Mailing Address - State:NEW BRUNSWICK
Mailing Address - Zip Code:E7H2H2
Mailing Address - Country:CA
Mailing Address - Phone:506-273-6351
Mailing Address - Fax:
Practice Address - Street 1:7 HATCH DR STE 290
Practice Address - Street 2:
Practice Address - City:CARIBOU
Practice Address - State:ME
Practice Address - Zip Code:04736-2095
Practice Address - Country:US
Practice Address - Phone:207-492-1653
Practice Address - Fax:207-492-1633
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC3838101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)