Provider Demographics
NPI:1679048441
Name:WILLIAMS, GAILYA LINETTE
Entity Type:Individual
Prefix:MS
First Name:GAILYA
Middle Name:LINETTE
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 1:3750 W 150TH PL
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46342-5336
Mailing Address - Country:US
Mailing Address - Phone:219-771-9387
Mailing Address - Fax:219-696-6183
Practice Address - Street 1:3750 W 150TH PL
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46342-5336
Practice Address - Country:US
Practice Address - Phone:219-771-9387
Practice Address - Fax:219-696-6183
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist