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Individual

MARY WILLIAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
INDEPENDENT

Contact information

Practice address
5635 MAIN ST STE A, ZACHARY, LA 70791-4083
(225) 489-9248
Mailing address
5635 MAIN ST STE A, ZACHARY, LA 70791-4083
(225) 489-9248

Taxonomy

Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
171M00000X
Case Manager/Care Coordinator
171W00000X
Contractor
Primary
172A00000X
Driver
174200000X
Meals Provider
176P00000X
Funeral Director
253Z00000X
In Home Supportive Care Agency
347C00000X
Private Vehicle

Other

Enumeration date
06/29/2023
Last updated
06/29/2023
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