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Individual

WILLIAM FREDERICK WATERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D

Contact information

Practice address
9001 SUMMA AVE, BATON ROUGE, LA 70809-3726
(225) 761-5200
(225) 761-5512
Mailing address
10310 THE GROVE BLVD, BATON ROUGE, LA 70836-6455
(225) 761-5200

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
347
LA
207RP1001X
Pulmonary Disease Physician
347
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1530760
LA
Enumeration date
07/11/2006
Last updated
09/12/2019
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