Provider Demographics
NPI:1811437510
Name:WILLIAMS, MORGAN JOYCE
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:JOYCE
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 1:130 PETERS DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-9352
Mailing Address - Country:US
Mailing Address - Phone:304-575-8432
Mailing Address - Fax:
Practice Address - Street 1:159 GRANBY CIR
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:WV
Practice Address - Zip Code:25813-9233
Practice Address - Country:US
Practice Address - Phone:304-575-8432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2016-3383225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist