Provider Demographics
NPI:1801273644
Name:WILLIAMS, ZACHARY ELIJAH
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:ELIJAH
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7761 PETITE PILLAR CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-0419
Mailing Address - Country:US
Mailing Address - Phone:626-616-6297
Mailing Address - Fax:
Practice Address - Street 1:7761 PETITE PILLAR CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-0419
Practice Address - Country:US
Practice Address - Phone:626-616-6297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health