Provider Demographics
NPI:1578113528
Name:WILLIAMS, TAWANDA LATOYA
Entity Type:Individual
Prefix:
First Name:TAWANDA
Middle Name:LATOYA
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:PO BOX 140435
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32614-0435
Mailing Address - Country:US
Mailing Address - Phone:352-225-3710
Mailing Address - Fax:888-763-7837
Practice Address - Street 1:901 NW 8TH AVE STE B3-1
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-5011
Practice Address - Country:US
Practice Address - Phone:888-763-7837
Practice Address - Fax:888-376-7135
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor