Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003040239 |
---|---|
Provider Name | Kesha Williams |
First Address | Los Angeles, CA 90008-5129 |
Second Address | Los Angeles, CA 90008-5129 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2009 |
Last Update Date | 01/05/2009 |