Provider Demographics
NPI:1225670656
Name:WILLIAMS, VERONICA LOUISE
Entity Type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:LOUISE
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 1:430 KLEINOW AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER ROUGE
Mailing Address - State:MI
Mailing Address - Zip Code:48218-1189
Mailing Address - Country:US
Mailing Address - Phone:313-695-1671
Mailing Address - Fax:
Practice Address - Street 1:7601 E JEFFERSON AVE APT 512
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-3720
Practice Address - Country:US
Practice Address - Phone:313-695-1671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care