Provider Demographics
NPI:1750118469
Name:WILLIAMS, D'NIQUA (DPT)
Entity type:Individual
Prefix:
First Name:D'NIQUA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 CORPORATION PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1362
Mailing Address - Country:US
Mailing Address - Phone:919-917-7729
Mailing Address - Fax:919-400-4178
Practice Address - Street 1:106 FARM BROOK DR UNIT C
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2178
Practice Address - Country:US
Practice Address - Phone:919-917-7729
Practice Address - Fax:919-400-4178
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP23604225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist