Provider Demographics
NPI:1770157141
Name:WILLIAMS, LINDY (LMT, MMP)
Entity type:Individual
Prefix:
First Name:LINDY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 OVERLAND LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-1073
Mailing Address - Country:US
Mailing Address - Phone:682-701-8018
Mailing Address - Fax:
Practice Address - Street 1:2309 OVERLAND LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-1073
Practice Address - Country:US
Practice Address - Phone:682-701-8018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX132987225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist