Provider Demographics
NPI:1023839776
Name:WILLIAMS-LEE, JADA ALEXIS
Entity type:Individual
Prefix:
First Name:JADA
Middle Name:ALEXIS
Last Name:WILLIAMS-LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:678 JAMESTOWN BLVD APT 2308
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-4696
Mailing Address - Country:US
Mailing Address - Phone:407-234-2201
Mailing Address - Fax:
Practice Address - Street 1:324 NEWBURYPORT AVE
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-3645
Practice Address - Country:US
Practice Address - Phone:844-244-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician