Williamson, Mary Todd

Williamson, Mary Todd is an individual health care provider with primary practice located at 3217 S Providence Rd , Columbia MO 65203-3639. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Williamson, Mary Todd can be contacted via phone (573) 884-7733.

Contact Information

Primary practice address
3217 S Providence Rd Columbia MO 65203-3639
Phone: (573) 884-7733
Fax: (573) 884-5559
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY01775 Missouri

Profile Details

NPI number 1821041021
LBN Legal business name Williamson, Mary Todd
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Sep 25th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821041021 NPPES
Missouri Other 680007308 RR MEDICARE
Missouri Other P00415787 RR MEDICARE
Missouri MEDICAID 498143601 RR MEDICARE

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