Provider Demographics
NPI:1639616196
Name:WILLIAMS, TATIA (PSYD, PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:TATIA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PSYD, PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 STOVER DR
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-8601
Mailing Address - Country:US
Mailing Address - Phone:740-417-9265
Mailing Address - Fax:740-417-9268
Practice Address - Street 1:106 STOVER DR
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-8601
Practice Address - Country:US
Practice Address - Phone:740-417-9265
Practice Address - Fax:740-417-9268
Is Sole Proprietor?:No
Enumeration Date:2017-01-23
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1100254-SUPV101YP2500X
OH7538103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional