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Individual

JERMICKA CHARMEIL WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9403 MANSFIELD RD, SHREVEPORT, LA 71118-3815
(318) 861-8938
Mailing address
PO BOX 4069, SHREVEPORT, LA 71134-0069
(318) 900-1311

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
176P00000X
Funeral Director
E2512
LA

Other

Enumeration date
09/07/2017
Last updated
09/07/2017
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