Provider Demographics
NPI:1740996537
Name:WILLIAMS, SHELIA DEVON
Entity type:Individual
Prefix:
First Name:SHELIA
Middle Name:DEVON
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4387 REESEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-2765
Mailing Address - Country:US
Mailing Address - Phone:706-615-8165
Mailing Address - Fax:
Practice Address - Street 1:4387 REESEWOOD CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-2765
Practice Address - Country:US
Practice Address - Phone:706-615-8165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty