Provider Demographics
NPI:1831675958
Name:WILLIAMS, DORREASE M
Entity Type:Individual
Prefix:
First Name:DORREASE
Middle Name:M
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 1:1008 PAINTED DAISY AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8787
Mailing Address - Country:US
Mailing Address - Phone:702-534-9762
Mailing Address - Fax:
Practice Address - Street 1:410 S RAMPART BLVD STE 347
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-5726
Practice Address - Country:US
Practice Address - Phone:702-466-5787
Practice Address - Fax:702-446-1673
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care