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General NPI Number Information
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NPI Number | 1952001836
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Entity Type | Individual
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Provider Name | CARNESHA WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 03/08/2023
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 25793 HIGHWAY 61
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City | ANGUILLA
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State | MS
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Zip | 38721-9565
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Country | US
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Telephone | 662-390-3195
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Fax |
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Provider Business Mailing Address
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Address Line | 132 BEALE ST
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City | HOLLANDALE
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State | MS
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Zip | 38748-9651
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Country | US
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Telephone | 662-390-3195
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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 | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number |
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License Number State |
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