Provider Demographics
NPI:1447018759
Name:WILLIAMS, MARY LESHAUN (LPN)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:LESHAUN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPN
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Mailing Address - Street 1:108 ROSCOMMON RD
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-6126
Mailing Address - Country:US
Mailing Address - Phone:205-657-9272
Mailing Address - Fax:
Practice Address - Street 1:375 BEAR CREEK RD
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-6261
Practice Address - Country:US
Practice Address - Phone:205-878-3016
Practice Address - Fax:205-634-5860
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty