Provider Information for 1922755974
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TRACI WILLIAMS LPCC
Sex: Female
NPI: 1922755974
Last Updated: 2022-03-08
Certification Date: 2022-03-08
Certification Date: 2022-03-08
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1922755974 | ||||||||
| Enumeration Date | 2022-03-08 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 804 S WALKER AVE SAN PEDRO, CA 90731-2920 United States Phone: 818-601-8330 | Fax: | ||||||||
| Primary Practice Address | 804 S WALKER AVE SAN PEDRO, CA 90731-2920 United States Phone: 818-601-8330 | Fax: | ||||||||
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