Provider Demographics
NPI:1891072807
Name:WILLIAMS, HAZEL HOLLIDAY (LCSW-BACS)
Entity Type:Individual
Prefix:MRS
First Name:HAZEL
Middle Name:HOLLIDAY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW-BACS
Other - Prefix:MRS
Other - First Name:HAZEL
Other - Middle Name:HOLLIDAY
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-BACS
Mailing Address - Street 1:4088 MOSS TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-7303
Mailing Address - Country:US
Mailing Address - Phone:225-658-7093
Mailing Address - Fax:225-658-7093
Practice Address - Street 1:4088 MOSS TRAIL DR
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-7303
Practice Address - Country:US
Practice Address - Phone:225-658-7093
Practice Address - Fax:225-658-7093
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical