Provider Demographics
NPI:1447033758
Name:WILLIAMS, KIMISHA JANAY-PATTERSON (LLMSW)
Entity type:Individual
Prefix:MRS
First Name:KIMISHA
Middle Name:JANAY-PATTERSON
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 RICCIUTI DR APT 904
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-6292
Mailing Address - Country:US
Mailing Address - Phone:734-645-0789
Mailing Address - Fax:
Practice Address - Street 1:555 AMORY ST STE 5
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2672
Practice Address - Country:US
Practice Address - Phone:617-383-6522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist