Provider Demographics
NPI:1134898497
Name:WILLIAMS, MIAO CHEN
Entity type:Individual
Prefix:MRS
First Name:MIAO
Middle Name:CHEN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MIAO
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MT-BC
Mailing Address - Street 1:2601 E THOMAS RD STE 115
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-8222
Mailing Address - Country:US
Mailing Address - Phone:480-692-8062
Mailing Address - Fax:
Practice Address - Street 1:4679 W IVANHOE ST
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226
Practice Address - Country:US
Practice Address - Phone:480-692-8062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16367225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist