Provider Demographics
NPI:1942790217
Name:WILLIAMS, WENDY ARLEEN (LICAC, DIPLAC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:ARLEEN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LICAC, DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 NH ROUTE 45
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:NH
Mailing Address - Zip Code:03084-4213
Mailing Address - Country:US
Mailing Address - Phone:603-801-2725
Mailing Address - Fax:
Practice Address - Street 1:360 ROUTE 101 BLDG. 1
Practice Address - Street 2:SUITE E
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110
Practice Address - Country:US
Practice Address - Phone:603-801-2725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-13
Last Update Date:2018-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH266171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2799OtherNCCAOM
NH266OtherLIC.AC., DIPL.AC. (NCCAOM)