Provider Demographics
NPI:1710133186
Name:WILLIAMS-VAUGHT, MARIE ALBERTA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:ALBERTA
Last Name:WILLIAMS-VAUGHT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:ALBERTA
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:5301 INDIAN HILL RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-7522
Mailing Address - Country:US
Mailing Address - Phone:405-513-2602
Mailing Address - Fax:405-348-4175
Practice Address - Street 1:5301 INDIAN HILL RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-7522
Practice Address - Country:US
Practice Address - Phone:405-513-2602
Practice Address - Fax:405-348-4175
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-17
Last Update Date:2008-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical