Provider Demographics
NPI:1255173225
Name:WILLIAMS, SHAQUELA C
Entity type:Individual
Prefix:
First Name:SHAQUELA
Middle Name:C
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 1:944 E 147TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-3732
Mailing Address - Country:US
Mailing Address - Phone:330-705-1937
Mailing Address - Fax:
Practice Address - Street 1:1008 E 152ND ST STE B
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-3300
Practice Address - Country:US
Practice Address - Phone:330-418-8351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker