Individual
CORNELIUS WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
803 W BAYOU PINES DR STE D, LAKE CHARLES, LA 70601-7096
(337) 304-7075
Mailing address
803 W BAYOU PINES DR STE D, LAKE CHARLES, LA 70601-7096
(337) 304-7075
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000
BH MENTAL HEALTH PROFESSIONAL
LA
Enumeration date
07/05/2016
Last updated
07/05/2016
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