Provider Demographics
NPI:1134458292
Name:WILLIAMS, DESIREE DIONE (DC)
Entity Type:Individual
Prefix:DR
First Name:DESIREE
Middle Name:DIONE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 OLD LIBERTY RD
Mailing Address - Street 2:STE 2
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-8500
Mailing Address - Country:US
Mailing Address - Phone:410-903-5798
Mailing Address - Fax:
Practice Address - Street 1:403 MALCOLM DR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6107
Practice Address - Country:US
Practice Address - Phone:410-876-8885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-18
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03604111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor