Individual
KANISE R WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCA
Contact information
Practice address
1941 BISHOP LN STE 1019, LOUISVILLE, KY 40218-1928
(502) 369-1036
Mailing address
3319 DUVALLE DR, LOUISVILLE, KY 40211-1967
(502) 489-1488
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
268330
KY
Other
Enumeration date
02/02/2021
Last updated
03/26/2021
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