Provider Demographics
NPI:1205138963
Name:WILLIAMS, INGRID (DPT, WCS)
Entity type:Individual
Prefix:MISS
First Name:INGRID
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DPT, WCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 324
Mailing Address - Street 2:
Mailing Address - City:NORTH BEACH
Mailing Address - State:MD
Mailing Address - Zip Code:20714-0324
Mailing Address - Country:US
Mailing Address - Phone:443-305-9577
Mailing Address - Fax:
Practice Address - Street 1:8927 ERIE AVE
Practice Address - Street 2:
Practice Address - City:NORTH BEACH
Practice Address - State:MD
Practice Address - Zip Code:20714-5009
Practice Address - Country:US
Practice Address - Phone:443-305-9577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37357174400000X
MD28699174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist