Provider Demographics
NPI:1417646480
Name:WILLIAMS, TASHA B
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:B
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 1:2414 CREST RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-1113
Mailing Address - Country:US
Mailing Address - Phone:513-349-4165
Mailing Address - Fax:
Practice Address - Street 1:2414 CREST RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-1113
Practice Address - Country:US
Practice Address - Phone:513-349-4165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide