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Individual

DESIREA WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3132 COLLEGE DR, BATON ROUGE, LA 70808-3180
(225) 952-0776
Mailing address
5483 HOWELL PARK AVE, BATON ROUGE, LA 70805-6234
(225) 573-9121

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
015171
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
015171
PHARMACY TECH LICENSE
LA
Enumeration date
08/06/2022
Last updated
08/06/2022
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