Provider Demographics
NPI:1508422122
Name:WILLIAMS, ANN LOUISE (LMT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:LOUISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4471 KNOB HILL DR
Mailing Address - Street 2:
Mailing Address - City:BELLBROOK
Mailing Address - State:OH
Mailing Address - Zip Code:45305-1428
Mailing Address - Country:US
Mailing Address - Phone:937-232-8895
Mailing Address - Fax:
Practice Address - Street 1:4471 KNOB HILL DR
Practice Address - Street 2:
Practice Address - City:BELLBROOK
Practice Address - State:OH
Practice Address - Zip Code:45305-1428
Practice Address - Country:US
Practice Address - Phone:937-232-8895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-20
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.008936225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist