Provider Demographics
NPI:1871228486
Name:WILLIAMSON, REBECCA DIANE
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:DIANE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7815 CLOVER CREEK CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-5216
Mailing Address - Country:US
Mailing Address - Phone:919-520-0002
Mailing Address - Fax:
Practice Address - Street 1:7815 CLOVER CREEK CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-5216
Practice Address - Country:US
Practice Address - Phone:919-520-0002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician