Provider Demographics
NPI:1578553996
Name:WILLIAMSON, PATRICIA (MA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 ASCOT RD
Mailing Address - Street 2:
Mailing Address - City:ORELAND
Mailing Address - State:PA
Mailing Address - Zip Code:19075-2222
Mailing Address - Country:US
Mailing Address - Phone:215-884-9884
Mailing Address - Fax:215-884-2482
Practice Address - Street 1:9425 STENTON AVE
Practice Address - Street 2:THE CARRIAGE HOUSE
Practice Address - City:ERDENHEIM
Practice Address - State:PA
Practice Address - Zip Code:19038-8231
Practice Address - Country:US
Practice Address - Phone:215-884-9884
Practice Address - Fax:215-884-2482
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000311106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2189567000OtherPERSONAL CHOICE