Provider Demographics
NPI:1508148149
Name:WILLIAMS, ELIZABETH
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
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 1:17052 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CUT OFF
Mailing Address - State:LA
Mailing Address - Zip Code:70345
Mailing Address - Country:US
Mailing Address - Phone:985-325-4327
Mailing Address - Fax:985-325-4328
Practice Address - Street 1:17052 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:CUT OFF
Practice Address - State:LA
Practice Address - Zip Code:70345
Practice Address - Country:US
Practice Address - Phone:985-325-4327
Practice Address - Fax:985-325-4328
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6428237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter