Provider Demographics
NPI:1144756206
Name:WILLIAMS, SHAWNTIE
Entity Type:Individual
Prefix:MS
First Name:SHAWNTIE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2439 MANHATTAN BLVD
Mailing Address - Street 2:STE. 403
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-5328
Mailing Address - Country:US
Mailing Address - Phone:504-368-5905
Mailing Address - Fax:504-368-5906
Practice Address - Street 1:2439 MANHATTAN BLVD
Practice Address - Street 2:STE. 403
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-5328
Practice Address - Country:US
Practice Address - Phone:504-368-5905
Practice Address - Fax:504-368-5906
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician