Provider Demographics
NPI:1790191229
Name:WILLIAMS, IRMA J (HHA)
Entity Type:Individual
Prefix:
First Name:IRMA
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12701 SHAKER BLVD APT 604
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-2087
Mailing Address - Country:US
Mailing Address - Phone:216-870-6640
Mailing Address - Fax:
Practice Address - Street 1:12701 SHAKER BLVD APT 604
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-2087
Practice Address - Country:US
Practice Address - Phone:216-870-6640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-04
Last Update Date:2014-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide