Provider Demographics
NPI:1629607296
Name:WILLIAMS, DEONTE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEONTE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVIANO HEALTH AND WELLNESS CENTER
Mailing Address - Street 2:
Mailing Address - City:AVIANO
Mailing Address - State:PORDENONE
Mailing Address - Zip Code:33081
Mailing Address - Country:IT
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AVIANO HEALTH AND WELLNESS CENTER
Practice Address - Street 2:
Practice Address - City:AVIANO
Practice Address - State:PORDENONE
Practice Address - Zip Code:33081
Practice Address - Country:IT
Practice Address - Phone:349-704-0997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-06
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06727103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical