Individual
CORNELIUS LARON WILLIAMS-FENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1601 COUNTY ROAD 57, PRATTVILLE, AL 36067-6800
(334) 361-9161
Mailing address
PO BOX 680710, PRATTVILLE, AL 36068-0710
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C3666A
AL
Other
Enumeration date
10/02/2020
Last updated
02/24/2021
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