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Individual

LAQUANDRA SHANTEE WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
STNA

Contact information

Practice address
1138 LEXINGTON AVE, COLUMBUS, OH 43201-2939
(614) 373-2856
Mailing address
1138 LEXINGTON AVE, COLUMBUS, OH 43201-2939
(614) 373-2856

Taxonomy

Speciality
Code
Description
License number
State
2472R0900X
Renal Dialysis Technician
DTI.005366
3747P1801X
Personal Care Attendant
Primary
0259743
OH
376K00000X
Nurse's Aide
400508605
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0259743
OH
Enumeration date
05/02/2018
Last updated
05/02/2018
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