Provider Demographics
NPI:1598574519
Name:WILLIAMS, YVETTE ANDREA (DPP LIFESTYLE COACH)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:ANDREA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DPP LIFESTYLE COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 COLONIAL ST # 2
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-3304
Mailing Address - Country:US
Mailing Address - Phone:860-726-3214
Mailing Address - Fax:
Practice Address - Street 1:43 TOWN CENTER SQ STE 102
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-7040
Practice Address - Country:US
Practice Address - Phone:800-945-9479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA174H00000X174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
568946544OtherBCBS
5874OtherHEALTH PARTNERS
DC236Medicaid