Provider Demographics
NPI:1437192515
Name:WILLIAMS, LAURA MARIE (MA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:HILLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:643 W CALDERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-8133
Mailing Address - Country:US
Mailing Address - Phone:208-318-8430
Mailing Address - Fax:208-593-3645
Practice Address - Street 1:643 W CALDERWOOD ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-8133
Practice Address - Country:US
Practice Address - Phone:208-318-8430
Practice Address - Fax:208-593-3645
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-7567101YP2500X
WALH00004161101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health