Individual
DEWAYNE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1610 JACKSON ST, MONROE, LA 71202-2030
(318) 512-5686
Mailing address
5405 BLANKS ST APT 42, MONROE, LA 71203-4767
(318) 512-5686
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
011038647
LA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/04/2017
Last updated
11/08/2018
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