Provider Demographics
NPI:1790377117
Name:MOORE-WILLIAMS, SONYA MARIA (HOME HEALTH AID)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:MARIA
Last Name:MOORE-WILLIAMS
Suffix:
Gender:F
Credentials:HOME HEALTH AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3541 OTTERBEIN AVE APT A
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-3935
Mailing Address - Country:US
Mailing Address - Phone:937-723-0463
Mailing Address - Fax:
Practice Address - Street 1:809 CLIFTON DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3667
Practice Address - Country:US
Practice Address - Phone:937-268-0878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health