Provider Demographics
NPI:1558976282
Name:WILLIAMS, MONIFA ALEXIE (DPT)
Entity Type:Individual
Prefix:DR
First Name:MONIFA
Middle Name:ALEXIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3232 E ELIDA ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-3221
Mailing Address - Country:US
Mailing Address - Phone:434-334-7107
Mailing Address - Fax:
Practice Address - Street 1:1040 S HARRISON RD STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85748-6601
Practice Address - Country:US
Practice Address - Phone:520-325-4002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-31474225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist