Provider Demographics
NPI:1942744370
Name:WILLIAMS, CAROL
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name: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 1:2465 HUTCHINSON LN
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3806
Mailing Address - Country:US
Mailing Address - Phone:810-655-0200
Mailing Address - Fax:
Practice Address - Street 1:2465 HUTCHINSON LN
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3806
Practice Address - Country:US
Practice Address - Phone:810-655-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-04
Last Update Date:2016-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor