Provider Demographics
NPI:1417405028
Name:WILLIAMS, SIMONA ALICIA (RDN, LD)
Entity Type:Individual
Prefix:
First Name:SIMONA
Middle Name:ALICIA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 LINDENBERG AVE
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5911
Mailing Address - Country:US
Mailing Address - Phone:256-766-6140
Mailing Address - Fax:256-852-2100
Practice Address - Street 1:333 LINDENBERG AVE
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5911
Practice Address - Country:US
Practice Address - Phone:256-766-6140
Practice Address - Fax:256-852-2100
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1650133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered