Healthcare Provider Details

I. General information

NPI: 1780181883
Provider Name (Legal Business Name): LORI ANN WILLIAMS PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 04/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2924 KNIGHT ST STE 426
SHREVEPORT LA
71105-2414
US

IV. Provider business mailing address

5320 LAURI LN
BOSSIER CITY LA
71112-4827
US

V. Phone/Fax

Practice location:
  • Phone: 318-754-3560
  • Fax: 318-779-0439
Mailing address:
  • Phone: 318-934-3997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPLC6761
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: