Provider Demographics
NPI:1699526921
Name:WILLIAMS, CAROL PATIENCE
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:PATIENCE
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 1:3503 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-2465
Mailing Address - Country:US
Mailing Address - Phone:216-798-2998
Mailing Address - Fax:
Practice Address - Street 1:3503 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-2465
Practice Address - Country:US
Practice Address - Phone:216-798-2998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist