Provider Demographics
NPI:1811626567
Name:WILLIAMS, PIEARRA MONIQUE
Entity Type:Individual
Prefix:
First Name:PIEARRA
Middle Name:MONIQUE
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 1:2407 CHEYENNE BLVD APT 115
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-1732
Mailing Address - Country:US
Mailing Address - Phone:419-215-3863
Mailing Address - Fax:
Practice Address - Street 1:2407 CHEYENNE BLVD APT 115
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1732
Practice Address - Country:US
Practice Address - Phone:419-215-3863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)