MEDICARE: CAR'VEIJA LAQUEATA WILLIAMS

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
1	106E00000X	Assistant Behavior Analyst

General Provider Information

NPI Number	:	1790614683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAR'VEIJA LAQUEATA WILLIAMS

Provider Business Mailing Address
First Line	:	201 S J ST APT 4
Second Line	:
City	:	LAKE WORTH BEACH
State	:	FL
Zip	:	33460-4152
Country	:	US
Telephone Number	:	239-895-6769
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 S J ST APT 4
Second Line	:
City	:	LAKE WORTH BEACH
State	:	FL
Zip	:	33460-4152
Country	:	US
Telephone Number	:	239-895-6769
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2026
Last Update Date	:	05/16/2026

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