Individual
DOMINIQUE LILLIAN MCCRAY WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC, EMT
Contact information
Practice address
11221 GALLERIA AVE, RALEIGH, NC 27614-8137
(919) 562-9410
(919) 562-9425
Mailing address
2000 CAMPANA DR, RALEIGH, NC 27603-9492
(919) 325-6065
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
P092137
NC
2255A2300X
Athletic Trainer
2000031606
NC
2255A2300X
Athletic Trainer
Primary
LAT-3877
NC
Other
Enumeration date
05/29/2018
Last updated
01/05/2023
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