Provider Demographics
NPI:1316036510
Name:WILLIAMS, ELENA NIKOLAYEVNA (LAC,DIPLOM,MSOM)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:NIKOLAYEVNA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LAC,DIPLOM,MSOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15720 E INDIAN BROOK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134
Mailing Address - Country:US
Mailing Address - Phone:303-332-8368
Mailing Address - Fax:
Practice Address - Street 1:15720 E INDIAN BROOK CIR
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134
Practice Address - Country:US
Practice Address - Phone:303-332-8368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1184171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist