Provider Demographics
NPI:1972833127
Name:WILLIAMS, ALICIA ANNA MARIE (EDD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:ANNA MARIE
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 1:30 DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-3908
Mailing Address - Country:US
Mailing Address - Phone:609-672-1385
Mailing Address - Fax:609-482-4109
Practice Address - Street 1:123 FRANKLIN CORNER RD
Practice Address - Street 2:SUITE 116
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2526
Practice Address - Country:US
Practice Address - Phone:609-672-1385
Practice Address - Fax:609-482-4109
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00322000101YP2500X
PAPC 003780101YP2500X
DEPC-0000392101YP2500X
NJ35SI00460500103T00000X
DEB1-0000869103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional