Provider Demographics
NPI:1891080826
Name:HARDISON-WILLIAMS, EDNA
Entity Type:Individual
Prefix:
First Name:EDNA
Middle Name:
Last Name:HARDISON-WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3912 N RICKEY DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73111-5211
Mailing Address - Country:US
Mailing Address - Phone:405-549-4025
Mailing Address - Fax:
Practice Address - Street 1:3912 N RICKEY DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73111-5211
Practice Address - Country:US
Practice Address - Phone:405-549-4025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst