Most Relevant Information
Provider Data
| NPI Number: | 1003288903 |
| Provider Name: | MALVANESE WILLIAMS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/30/2015 |
| Last Updated: | 11/02/2018 |
Provider Practice Location
809 COLLEGE ST
SHREVEPORT
LA
711042928
Practice Location Phone/Fax
| Phone: | 3186586099 |
| Fax: |
Provider Mailing Location
809 COLLEGE ST
SHREVEPORT
LA
711042928
Provider Mailing Phone/Fax
| Phone: | 3186586099 |
| Fax: |