Provider Demographics
NPI:1013052869
Name:WILLIAMS, TERI MECHELL
Entity Type:Individual
Prefix:MRS
First Name:TERI
Middle Name:MECHELL
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:TERI
Other - Middle Name:JO
Other - Last Name:MECHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:122 S KANSAS ST
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-5446
Mailing Address - Country:US
Mailing Address - Phone:580-650-9593
Mailing Address - Fax:
Practice Address - Street 1:122 S KANSAS ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-5446
Practice Address - Country:US
Practice Address - Phone:580-650-9593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health