Individual
LARAE A WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
2801 BUFORD HWY NE, SUITE #540, BROOKHAVEN, GA 30329-2149
(678) 825-5371
Mailing address
2801 BUFORD HWY NE, SUITE #540, BROOKHAVEN, GA 30329-2149
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
GA003466
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003110763
—
GA
Enumeration date
08/04/2008
Last updated
03/09/2015
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