| Doctor Name: | MR. AVERY LA-MONT WILLIAMS |
| NPI Number: | 1609098979 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | REGISTERED NURSE |
| License Number: | R0070988 |
| Business Practice Address: | 3029 Hillside Dr Del City, OK - 731151847 |
| Business Phone Number: | 4052781573 |
| Business Fax Number: | |
| Mailing Address: | 3029 Hillside Dr, DEL CITY |
| State: | OK |
| Postal Code: | 731151847 |
| Phone Number: | 4052781573 |
| Fax Number: | |
| NPI Enumeration Date: | 05/03/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WA0400X |
| License Number: | R0070988 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |