Provider Demographics
NPI:1588553200
Name:WILLIAMS, MONIQUE (CPT)
Entity type:Individual
Prefix:MRS
First Name:MONIQUE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 LAKEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-1713
Mailing Address - Country:US
Mailing Address - Phone:678-699-9612
Mailing Address - Fax:
Practice Address - Street 1:969 LAKEVIEW RD
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:GA
Practice Address - Zip Code:30017-1713
Practice Address - Country:US
Practice Address - Phone:678-699-9612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy