Provider Demographics
NPI:1891218111
Name:WILLIAMS, TYJA J
Entity Type:Individual
Prefix:
First Name:TYJA
Middle Name:J
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 1:617 1/2 ELIZA ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-4123
Mailing Address - Country:US
Mailing Address - Phone:985-381-9667
Mailing Address - Fax:
Practice Address - Street 1:1836 SAINT BERNARD AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70116-1329
Practice Address - Country:US
Practice Address - Phone:504-943-1857
Practice Address - Fax:504-943-1858
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health