Doctor Name: | LARAE A WILLIAMS |
NPI Number: | 1013173673 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D |
License Number: | GA003466 |
Business Practice Address: | 2801 Buford Hwy Ne Suite #540 Brookhaven, GA - 303292149 |
Business Phone Number: | 6788255371 |
Business Fax Number: | |
Mailing Address: | 2801 Buford Hwy Ne, Suite #540 BROOKHAVEN |
State: | GA |
Postal Code: | 303292149 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/04/2008 |
NPI Last Update Date: | 03/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | GA003466 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |