Individual
DEZIRAE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1448 WILEY ST, FAIRBORN, OH 45324-3246
(937) 284-2071
Mailing address
1448 WILEY ST, FAIRBORN, OH 45324-3246
(937) 284-2071
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.188036
OH
Other
Enumeration date
02/13/2024
Last updated
02/13/2024
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