Provider Demographics
NPI:1083840490
Name:WILLIAMS, LAURA L (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 CHATHAM LN
Mailing Address - Street 2:SUITE 112
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2418
Mailing Address - Country:US
Mailing Address - Phone:614-754-7648
Mailing Address - Fax:
Practice Address - Street 1:921 CHATHAM LN
Practice Address - Street 2:SUITE 112
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2418
Practice Address - Country:US
Practice Address - Phone:614-754-7648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5567103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent