Provider Demographics
NPI:1467066027
Name:WILLIAMS, MICHELLE KAYLA
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:KAYLA
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 1:7121 W BELL RD # 115
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8555
Mailing Address - Country:US
Mailing Address - Phone:623-688-0709
Mailing Address - Fax:
Practice Address - Street 1:7121 W BELL RD # 115
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8555
Practice Address - Country:US
Practice Address - Phone:623-688-0709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-6587T101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional