Provider Demographics
NPI:1639389406
Name:WILLIAMS, TOBY LYNN (MT-BC, LCAT)
Entity type:Individual
Prefix:
First Name:TOBY
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MT-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 1ST ST # 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-2507
Mailing Address - Country:US
Mailing Address - Phone:347-678-9584
Mailing Address - Fax:
Practice Address - Street 1:407 1ST ST # 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-2507
Practice Address - Country:US
Practice Address - Phone:347-678-9584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000537221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist