Provider Demographics
NPI:1538233713
Name:NUNOO WILLIAMS, PHYLLIS CORNELLA (MSW LCSW)
Entity type:Individual
Prefix:MS
First Name:PHYLLIS
Middle Name:CORNELLA
Last Name:NUNOO WILLIAMS
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:MS
Other - First Name:PHYLLIS
Other - Middle Name:CORNELIA
Other - Last Name:NHNOO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW LCSW
Mailing Address - Street 1:PO BOX 50406
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73140-5405
Mailing Address - Country:US
Mailing Address - Phone:405-741-1591
Mailing Address - Fax:405-741-1593
Practice Address - Street 1:7901 NE 10TH STREET
Practice Address - Street 2:SUITE B202
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-7453
Practice Address - Country:US
Practice Address - Phone:405-741-1591
Practice Address - Fax:405-741-1593
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK04241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical