Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 4611 | LA |
N | 101YP1600X | Pastoral Counselor | LA | |
Y | 101YP2500X | Professional Counselor | 4611 | LA |
N | 103K00000X | Behavior Analyst | LA |
NPI | 1184985020 |
---|---|
Provider Name | Ms. Marilyn Louise Williams |
First Address | Lake Charles, LA 70601-9405 |
Second Address | Lake Charles, LA 70601-9405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2012 |
Last Update Date | 07/06/2012 |