Provider Demographics
NPI:1497368104
Name:WILLIAMS, MARNIE KATHLEEN NOELLE (BCBA)
Entity Type:Individual
Prefix:
First Name:MARNIE
Middle Name:KATHLEEN NOELLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:MARNIE
Other - Middle Name:KATHLEEN NOELLE
Other - Last Name:CHRISTISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:417 MACE BLVD
Mailing Address - Street 2:SUITE J #114
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618
Mailing Address - Country:US
Mailing Address - Phone:530-574-0556
Mailing Address - Fax:
Practice Address - Street 1:417 MACE BLVD
Practice Address - Street 2:SUITE J #114
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618-4522
Practice Address - Country:US
Practice Address - Phone:530-574-0556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst