Provider Demographics
NPI:1265279558
Name:WILLIAMS, MARICHA DOMINIQUE
Entity type:Individual
Prefix:
First Name:MARICHA
Middle Name:DOMINIQUE
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 1:2550 TALBOTT AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-8122
Mailing Address - Country:US
Mailing Address - Phone:513-226-0379
Mailing Address - Fax:
Practice Address - Street 1:2550 TALBOTT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-8122
Practice Address - Country:US
Practice Address - Phone:513-226-0379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No172A00000XOther Service ProvidersDriver
No251X00000XAgenciesSupports Brokerage
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child