Provider Demographics
NPI:1932715869
Name:WILLIAMS, TATIANA L (MA)
Entity Type:Individual
Prefix:MS
First Name:TATIANA
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8312 GOVERNOR GRAYSON WAY
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-3450
Mailing Address - Country:US
Mailing Address - Phone:443-255-9676
Mailing Address - Fax:
Practice Address - Street 1:1520 HAMBLEDON LOOP
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3318
Practice Address - Country:US
Practice Address - Phone:443-255-9676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist