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NPI Code Detail

MEDICARE: MRS. DONDRA LAKESHA WILLIAMS LMSW

MEDICARE: MRS. DONDRA LAKESHA WILLIAMS LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerMSW010133GA

General Provider Information

NPI Number : 1518666718
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DONDRA LAKESHA WILLIAMS LMSW
Provider Business Mailing Address
First Line : PO BOX 304
Second Line :
City : FORTSON
State : GA
Zip : 31808-0304
Country : US
Telephone Number : 706-505-3645
Fax Number :
Provider Business Practice Location Address
First Line : 6910 RIVER RD
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-2316
Country : US
Telephone Number : 800-214-8387
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2023
Last Update Date : 02/27/2023

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