Provider Demographics
NPI:1700081262
Name:WILLIAMS, CARLA JUNE (MS)
Entity type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:JUNE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4222 W CAPITOL DR
Mailing Address - Street 2:SUITE LL
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2500
Mailing Address - Country:US
Mailing Address - Phone:414-810-4431
Mailing Address - Fax:
Practice Address - Street 1:4222 W CAPITOL DR
Practice Address - Street 2:SUITE LL
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2500
Practice Address - Country:US
Practice Address - Phone:414-810-4431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health