Provider Demographics
NPI:1366953432
Name:WILLIAMS, DEANNA GRACE (BSW, S/T)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:GRACE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:BSW, S/T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 AUTUMN VILLAGE CT
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-7578
Mailing Address - Country:US
Mailing Address - Phone:954-579-3805
Mailing Address - Fax:
Practice Address - Street 1:250 GEORGIA AVE SE STE 206
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-3000
Practice Address - Country:US
Practice Address - Phone:404-653-0374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health