Provider Demographics
NPI:1184722662
Name:WILLIAMS, JENNIFER NICOLE (MS)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:NICOLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:55 DODGE RD
Mailing Address - Street 2:
Mailing Address - City:GETZVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14068-1205
Mailing Address - Country:US
Mailing Address - Phone:716-831-2700
Mailing Address - Fax:716-831-1818
Practice Address - Street 1:1370 NIAGARA FALLS BLVD
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-8441
Practice Address - Country:US
Practice Address - Phone:716-833-3708
Practice Address - Fax:716-833-3711
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)