Provider Demographics
NPI:1801547344
Name:MAXWELL-WILLIAMS, RIAN
Entity type:Individual
Prefix:
First Name:RIAN
Middle Name:
Last Name:MAXWELL-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 1:890 WAKEHURST PL
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-4734
Mailing Address - Country:US
Mailing Address - Phone:404-274-4662
Mailing Address - Fax:
Practice Address - Street 1:3720 CHAMBLEE DUNWOODY RD STE D2
Practice Address - Street 2:
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-2064
Practice Address - Country:US
Practice Address - Phone:678-802-9355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling