Provider Demographics
NPI:1629202882
Name:WILLIAMS, LATASHA DUBOISE (RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:LATASHA
Middle Name:DUBOISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 ROSE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-6706
Mailing Address - Country:US
Mailing Address - Phone:919-327-0219
Mailing Address - Fax:
Practice Address - Street 1:1133 ROSE RIDGE DR
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-6706
Practice Address - Country:US
Practice Address - Phone:919-327-0219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003320133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered