Provider Demographics
NPI:1770969016
Name:PALEY-WILLIAMS, MIRIAM ALICE
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:ALICE
Last Name:PALEY-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 1:150 CENTRAL PARK SQ # 29
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-4026
Mailing Address - Country:US
Mailing Address - Phone:408-355-5248
Mailing Address - Fax:
Practice Address - Street 1:150 CENTRAL PARK SQ # 29
Practice Address - Street 2:
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-4026
Practice Address - Country:US
Practice Address - Phone:510-214-6261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2024-0041106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist