Provider Demographics
NPI:1649953142
Name:WILLIAMS, LAQUINA
Entity type:Individual
Prefix:MS
First Name:LAQUINA
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 1:4134 FLORDIA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70062
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4134 FLORDIA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70062
Practice Address - Country:US
Practice Address - Phone:504-201-3230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6086402342000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company