Provider Demographics
NPI:1972822443
Name:WILLIAMS, MOLLIE ANN (EDD)
Entity Type:Individual
Prefix:DR
First Name:MOLLIE
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 N WESTMORELAND RD
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2269
Mailing Address - Country:US
Mailing Address - Phone:214-769-4403
Mailing Address - Fax:
Practice Address - Street 1:1801 N WESTMORELAND RD
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2269
Practice Address - Country:US
Practice Address - Phone:214-769-4403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7848101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health