Provider Demographics
NPI:1104051986
Name:WILLIAMS, VALARIE MASHEA' (LMBT)
Entity type:Individual
Prefix:MS
First Name:VALARIE
Middle Name:MASHEA'
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4316 PRESLEY CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-9074
Mailing Address - Country:US
Mailing Address - Phone:919-758-7701
Mailing Address - Fax:
Practice Address - Street 1:4316 PRESLEY CT STE 103
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-9074
Practice Address - Country:US
Practice Address - Phone:919-758-7701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-21
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC08773225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist