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Individual

BRIDGETTE WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
419 WASHINGTON STREET, MANSFIELD, LA 71052
(318) 872-0262
Mailing address
419 WASHINGTON STREET, SHREVEPORT, LA 71052

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101YM0800X
LA
Enumeration date
11/02/2017
Last updated
11/02/2017
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