Provider Demographics
NPI:1770010811
Name:WILLIAMS, JANIQUA N (BA, LSW, CDCA)
Entity Type:Individual
Prefix:
First Name:JANIQUA
Middle Name:N
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:BA, LSW, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7015 SPRING MEADOWS WEST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528
Mailing Address - Country:US
Mailing Address - Phone:419-491-1180
Mailing Address - Fax:419-491-1181
Practice Address - Street 1:7015 SPRING MEADOWS WEST
Practice Address - Street 2:SUITE 102
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528
Practice Address - Country:US
Practice Address - Phone:419-491-1180
Practice Address - Fax:419-491-1181
Is Sole Proprietor?:No
Enumeration Date:2017-05-19
Last Update Date:2017-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker