Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
Y | 103G00000X | Clinical Psychologist | ||
Y | 103TC0700X | Clinical Psychologist | ||
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103TF0200X | Forensic Psychologist | ||
N | 103TP0016X | Prescribing (Medical) | ||
N | 103TP2701X | Group Psychotherapist | ||
N | 103TR0400X | Rehabilitation Psychologist | ||
N | 103TS0200X | School Psychologist |
NPI | 1073826186 |
---|---|
Provider Name | Dr. Roquel A Williams |
First Address | Shreveport, LA 71106-4404 |
Second Address | Shreveport, LA 71106-4404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2010 |
Last Update Date | 25/08/2010 |