Provider Demographics
NPI:1558616888
Name:WILLIAMS, ALEDIA NEDRA (MS, RD, LDN, CLC)
Entity Type:Individual
Prefix:
First Name:ALEDIA
Middle Name:NEDRA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS, RD, LDN, CLC
Other - Prefix:
Other - First Name:ALEDIA
Other - Middle Name:NEDRA
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, RD, LDN, CLC
Mailing Address - Street 1:2913 MAX DR
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-5613
Mailing Address - Country:US
Mailing Address - Phone:504-214-2434
Mailing Address - Fax:504-568-8232
Practice Address - Street 1:2913 MAX DR
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-5613
Practice Address - Country:US
Practice Address - Phone:504-214-2434
Practice Address - Fax:504-568-8232
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA986133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered