Provider Demographics
NPI:1164009155
Name:WILLIAMS, SHENEQUA LASHEA
Entity Type:Individual
Prefix:
First Name:SHENEQUA
Middle Name:LASHEA
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 1:409 CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-6031
Mailing Address - Country:US
Mailing Address - Phone:337-422-8597
Mailing Address - Fax:
Practice Address - Street 1:409 CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6031
Practice Address - Country:US
Practice Address - Phone:337-422-8597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator