Provider Demographics
NPI:1861968448
Name:WILLIAMS, KORBIN (BCBA)
Entity type:Individual
Prefix:
First Name:KORBIN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:TX
Mailing Address - Zip Code:79360-0010
Mailing Address - Country:US
Mailing Address - Phone:210-859-5185
Mailing Address - Fax:
Practice Address - Street 1:2409 W ILLINOIS AVE STE D
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6308
Practice Address - Country:US
Practice Address - Phone:432-695-9913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst