Provider Demographics
NPI:1699358341
Name:WILLAIMS, TRICHELL
Entity Type:Individual
Prefix:
First Name:TRICHELL
Middle Name:
Last Name:WILLAIMS
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 1:3826 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-1320
Mailing Address - Country:US
Mailing Address - Phone:937-634-9001
Mailing Address - Fax:
Practice Address - Street 1:3826 W 2ND ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-1320
Practice Address - Country:US
Practice Address - Phone:937-634-9001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty