Individual
DANTE' DE'SHAWN WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3712 MACARTHUR BLVD STE 100, NEW ORLEANS, LA 70114-6861
(504) 882-8105
Mailing address
3712 MACARTHUR BLVD STE 100, NEW ORLEANS, LA 70114-6861
(504) 882-8105
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1543866586
TRICARE
LA
05
—
7279765248912
—
LA
Enumeration date
03/20/2019
Last updated
03/20/2019
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