Provider Demographics
NPI:1871028092
Name:WILLIAMS, JUDY
Entity Type:Individual
Prefix:
First Name:JUDY
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 1:373 SAIZAN AVE
Mailing Address - Street 2:
Mailing Address - City:PORT BARRE
Mailing Address - State:LA
Mailing Address - Zip Code:70577
Mailing Address - Country:US
Mailing Address - Phone:337-308-4200
Mailing Address - Fax:
Practice Address - Street 1:373 SAIZAN AVE
Practice Address - Street 2:BOX 461
Practice Address - City:PORT BARRE
Practice Address - State:LA
Practice Address - Zip Code:70577-0461
Practice Address - Country:US
Practice Address - Phone:337-308-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor