Provider Demographics
NPI:1811218183
Name:WILLIAMS, BRYMAN ERIC (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRYMAN
Middle Name:ERIC
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 N LIVINGSTON RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-8713
Mailing Address - Country:US
Mailing Address - Phone:601-750-4797
Mailing Address - Fax:601-605-2086
Practice Address - Street 1:1100 S 4TH ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-2804
Practice Address - Country:US
Practice Address - Phone:318-600-6273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1396103TC0700X
MS48843103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical