Bruce Sidney Williams
Individual provider Active NPI Behavior Technician · Ludowici, GA
NPI 1104450220 · NPPES record last updated Feb 27, 2020
Key facts
- NPI
- 1104450220
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 63 Fury Lane NE
Ludowici, GA 31316 - Phone
- (785) 492-8390
- NPI assigned
- Feb 27, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
63 Fury Lane NE
Ludowici, GA 31316
Mailing address
316 Mid Valley Ctr Ste 186
Carmel, CA 93923-8516
Other providers in Ludowici, GA
- Marra Stone
- Melissa D Thomas
- John Stanford Townsend
- Triple C Speech Language Pathology LLC
- Janise Wallace
- Maureen Dunn Wilson
- Iris Worthy
All providers in Ludowici, GA · Behavior Technician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.