Provider Demographics
NPI:1508672254
Name:WILLIAM-JARVIS, PRINCESS V (LMSW)
Entity type:Individual
Prefix:
First Name:PRINCESS
Middle Name:V
Last Name:WILLIAM-JARVIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1931 MARKET CENTER BLVD APT 4114
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75207-3400
Mailing Address - Country:US
Mailing Address - Phone:510-990-1026
Mailing Address - Fax:
Practice Address - Street 1:1931 MARKET CENTER BLVD APT 4114
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-3400
Practice Address - Country:US
Practice Address - Phone:510-990-1026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-07
Last Update Date:2024-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113599104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker