Individual
LAQUEENA T WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1215 FARMINGTON AVENUE, BRISTOL, CT 06010-6010
(860) 516-5931
Mailing address
21 GRAND ST, HARTFORD, CT 06106-1541
(843) 206-9430
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5152
CT
Other
Enumeration date
08/30/2019
Last updated
08/03/2022
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