Provider Demographics
NPI:1609546795
Name:RENEE ANN WILLIAMS A MARRIAGE AND FAMILY THERAPY PROFESSIONAL CORP
Entity type:Organization
Organization Name:RENEE ANN WILLIAMS A MARRIAGE AND FAMILY THERAPY PROFESSIONAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:916-865-6833
Mailing Address - Street 1:5098 FOOTHILLS BLVD STE 3-134
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-6526
Mailing Address - Country:US
Mailing Address - Phone:916-865-6833
Mailing Address - Fax:
Practice Address - Street 1:2200-B DOUGLAS BLVD STE 140
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4292
Practice Address - Country:US
Practice Address - Phone:916-865-6833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty