Provider Demographics
NPI:1720402696
Name:WILLIAMS, MARK S (MED, BCBA)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:S
Last Name:WILLIAMS
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Gender:M
Credentials:MED, BCBA
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Mailing Address - Street 1:83 PINE ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-3646
Mailing Address - Country:US
Mailing Address - Phone:978-717-5062
Mailing Address - Fax:978-717-5064
Practice Address - Street 1:83 PINE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-3646
Practice Address - Country:US
Practice Address - Phone:978-717-5062
Practice Address - Fax:978-717-5064
Is Sole Proprietor?:No
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst