Provider Demographics
NPI:1013319680
Name:WILLIAMS, ZITA (PHD)
Entity Type:Individual
Prefix:
First Name:ZITA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5975 W SUNRISE BLVD
Mailing Address - Street 2:115
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313-6800
Mailing Address - Country:US
Mailing Address - Phone:954-368-6856
Mailing Address - Fax:954-400-7394
Practice Address - Street 1:5975 W SUNRISE BLVD
Practice Address - Street 2:115
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313-6800
Practice Address - Country:US
Practice Address - Phone:954-368-6856
Practice Address - Fax:954-400-7394
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13803101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral