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Individual

DEANNA L WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3757 SANTA ROSALIA DRIVE, #628, LOS ANGELES, CA 90008
(404) 750-5623
Mailing address
PO BOX 191456, LOS ANGELES, CA 90019-9456
(404) 750-5623

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103TC1900X
Counseling Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
954505783
CA
Enumeration date
06/12/2017
Last updated
06/12/2017
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