Individual
MS. RONNIE DALE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA , CMT
Contact information
Practice address
7683 W RIVERSIDE DR, BOISE, ID 83714-6188
(208) 853-2227
Mailing address
9415 THURMAN DR APT 7, BOISE, ID 83714-1161
(208) 302-0378
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MX060119
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00078560602
IDAHONURSEAIDE PROGRAM
ID
Enumeration date
03/11/2008
Last updated
03/19/2008
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