Individual
MRS. TASHARA D WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3615 CRESTVIEW CIR, SHREVEPORT, LA 71119-6522
(940) 230-0211
Mailing address
3615 CRESTVIEW CIR, SHREVEPORT, LA 71119-6522
(940) 230-0211
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6472
LA
164W00000X
Licensed Practical Nurse
282572
LA
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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