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General NPI Number Information
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NPI Number | 1437858867
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Entity Type | Individual
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Provider Name | CHARKELIA STATE WILLIAMS MPA/PSS
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Gender | Female
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Dates
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Enumeration Date | 02/24/2023
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Last Update Date | 02/24/2023
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Provider Practice Location Address
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Address Line | 1808 GLENMAR AVE
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City | MONROE
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State | LA
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Zip | 71201-4932
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Country | US
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Telephone | 318-614-2067
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Fax |
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Provider Business Mailing Address
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Address Line | 628 PLEASANT HILL RD
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City | FARMERVILLE
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State | LA
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Zip | 71241-8108
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Country | US
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Telephone | 318-614-2067
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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