Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND-114 | CA |
NPI | 1083822613 |
---|---|
Provider Name | Dr. Louisa Lyles Williams |
First Address | Kelseyville, CA 95451-9191 |
Second Address | Novato, CA 94949-6226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 08/07/2007 |