Provider Demographics
NPI:1699254102
Name:WILLIAMS, LEAH TERESA (BACHELOR OF SCIENCE)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:TERESA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:BACHELOR OF SCIENCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 COLES LDG
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-2955
Mailing Address - Country:US
Mailing Address - Phone:985-703-0440
Mailing Address - Fax:
Practice Address - Street 1:406 COLES LDG
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-2955
Practice Address - Country:US
Practice Address - Phone:985-703-0440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator