Individual
LAVIDA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
503 W OCEAN BLVD, LOS FRESNOS, TX 78566-3635
(956) 943-9600
Mailing address
210 E JEFFERSON ST, PORT ISABEL, TX 78578-4212
(361) 903-0363
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
117569
TX
Other
Enumeration date
03/21/2016
Last updated
03/21/2016
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