Provider Demographics
NPI:1578995635
Name:WILLIAMS, CARMEN SUSANNE (MS)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:SUSANNE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 WASHINGTON ST STE 4100
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-5900
Mailing Address - Country:US
Mailing Address - Phone:816-932-4576
Mailing Address - Fax:
Practice Address - Street 1:4321 WASHINGTON ST STE 4100
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5900
Practice Address - Country:US
Practice Address - Phone:816-932-4576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL246000197170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS