Provider Demographics
NPI:1124883004
Name:WILLIAMS, GIESEL TRICIA (LMT)
Entity type:Individual
Prefix:MS
First Name:GIESEL
Middle Name:TRICIA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14199 BLANKET FLOWER LN APT 103
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-8724
Mailing Address - Country:US
Mailing Address - Phone:317-431-2222
Mailing Address - Fax:
Practice Address - Street 1:600 E CARMEL DR STE 101
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2805
Practice Address - Country:US
Practice Address - Phone:317-431-3222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INMT21706135225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist