Provider Demographics
NPI:1215982384
Name:WILLIAMS, ALTHEA
Entity type:Individual
Prefix:MRS
First Name:ALTHEA
Middle Name:
Last Name:WILLIAMS
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 1:5620 SAINT CLAUDE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70117-2534
Mailing Address - Country:US
Mailing Address - Phone:504-945-8118
Mailing Address - Fax:504-328-5412
Practice Address - Street 1:5620 SAINT CLAUDE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70117-2534
Practice Address - Country:US
Practice Address - Phone:504-945-8118
Practice Address - Fax:504-328-5412
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA92973747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1101851Medicaid