Individual
MRS. KANISHA L WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17539 ALACK DR, HAMMOND, LA 70403-0243
(985) 345-2957
Mailing address
17539 ALACK DR, HAMMOND, LA 70403-0243
(985) 345-2957
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
010580053
LA
Other
Enumeration date
07/16/2014
Last updated
07/16/2014
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