Provider Demographics
NPI:1316786213
Name:WILLIAMS, LAQUINESHA D (LMT,C-MLD)
Entity type:Individual
Prefix:MS
First Name:LAQUINESHA
Middle Name:D
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMT,C-MLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 OPELIKA RD APT 120
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-3921
Mailing Address - Country:US
Mailing Address - Phone:850-728-7647
Mailing Address - Fax:
Practice Address - Street 1:412 OPELIKA RD APT 120
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-3921
Practice Address - Country:US
Practice Address - Phone:850-728-7647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5932225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist