Provider Demographics
NPI:1982190021
Name:WILLIAMS, ROBERT LEE JR
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEE
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2772 MARTIN LUTHER KING JR. BLVD.
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93706-2257
Mailing Address - Country:US
Mailing Address - Phone:559-265-4800
Mailing Address - Fax:559-265-4823
Practice Address - Street 1:2772 MARTIN LUTHER KING JR.
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706
Practice Address - Country:US
Practice Address - Phone:559-265-4800
Practice Address - Fax:559-265-4823
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)