Provider Demographics
NPI:1528348935
Name:WILLIAMS, ELIZABETH KAY
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KAY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4951 TAMIAMI TRL N # 103
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-3067
Mailing Address - Country:US
Mailing Address - Phone:239-262-1505
Mailing Address - Fax:
Practice Address - Street 1:4951 TAMIAMI TRL N # 103
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3067
Practice Address - Country:US
Practice Address - Phone:239-262-1505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0004385225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist