Provider Demographics
NPI:1922040047
Name:WILLIAMS, WILLIAM WATTS (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:WATTS
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4434 WINDSOR FARM RD
Mailing Address - Street 2:
Mailing Address - City:HARWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20776-2201
Mailing Address - Country:US
Mailing Address - Phone:443-994-8770
Mailing Address - Fax:410-867-6064
Practice Address - Street 1:4434 WINDSOR FARM RD
Practice Address - Street 2:
Practice Address - City:HARWOOD
Practice Address - State:MD
Practice Address - Zip Code:20776-2201
Practice Address - Country:US
Practice Address - Phone:443-994-8770
Practice Address - Fax:410-867-6064
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01267103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD01267OtherMARYLAND LICENSE
MD214100100Medicaid