Individual
ANTOINAY WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2715 MACKEY LN, SHREVEPORT, LA 71118-2556
(318) 617-3504
Mailing address
2715 MACKEY LN, SHREVEPORT, LA 71118-2556
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003279654
—
LA
Enumeration date
10/03/2016
Last updated
10/03/2016
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