Provider Demographics
NPI:1134456312
Name:WILLIAMS, ROBYN L (MA)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7214 GIDDINGS DR
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-2611
Mailing Address - Country:US
Mailing Address - Phone:240-354-9688
Mailing Address - Fax:240-764-6741
Practice Address - Street 1:9701 APOLLO DR
Practice Address - Street 2:SUITE 441
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-4783
Practice Address - Country:US
Practice Address - Phone:240-354-9688
Practice Address - Fax:240-764-6741
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3193101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLC3193OtherLICENSE NUMBER