Provider Demographics
NPI:1972052710
Name:WILLIAMS, ANNA MARIA (CERTHAIRLOSSSPECIAL)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:MARIA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CERTHAIRLOSSSPECIAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10843 KINGSTON PIKE
Mailing Address - Street 2:SUITE 16
Mailing Address - City:FARRAGUT
Mailing Address - State:TN
Mailing Address - Zip Code:37934-3054
Mailing Address - Country:US
Mailing Address - Phone:865-924-5885
Mailing Address - Fax:
Practice Address - Street 1:10843 KINGSTON PIKE
Practice Address - Street 2:SUITE 16
Practice Address - City:FARRAGUT
Practice Address - State:TN
Practice Address - Zip Code:37934-3054
Practice Address - Country:US
Practice Address - Phone:865-924-5885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-21
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management