Provider Demographics
NPI:1891527578
Name:WILLIAMS, BRENDA SHREE
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:SHREE
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 1:26 PETERBORO ST
Mailing Address - Street 2:APT 605
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2785
Mailing Address - Country:US
Mailing Address - Phone:313-659-8881
Mailing Address - Fax:
Practice Address - Street 1:26 PETERBORO ST
Practice Address - Street 2:APT 605
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2785
Practice Address - Country:US
Practice Address - Phone:313-659-8881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider