Individual
DAMETA DIANE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASTER ESTHETICIAN
Contact information
Practice address
3525 LAKE AVE, FORT WAYNE, IN 46805-5599
(260) 201-2000
Mailing address
478 GREENPOINTE PKWY, FORT WAYNE, IN 46814-7611
(260) 201-2000
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
IN
Other
Enumeration date
10/21/2020
Last updated
10/21/2020
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