Individual
AUTUMNE LACHISA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
2080 S E ST, SAN BERNARDINO, CA 92408-2773
(909) 388-9191
Mailing address
2080 S E ST, SAN BERNARDINO, CA 92408-2773
(909) 388-9191
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
33116
CA
Other
Enumeration date
09/06/2018
Last updated
03/03/2020
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