Doctor Name: | MRS. LISA DANSBY WILLIAMS |
NPI Number: | 1023122348 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, LAC |
License Number: | A0209063 |
Business Practice Address: | 100 Rivendell Dr Benton, AR - 720159188 |
Business Phone Number: | 5013161255 |
Business Fax Number: | 5013162221 |
Mailing Address: | 1100 Brookside Dr Apt 78, LITTLE ROCK |
State: | AR |
Postal Code: | 722275781 |
Phone Number: | 5012244010 |
Fax Number: | |
NPI Enumeration Date: | 08/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | A0209063 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |