Individual
DOMINIQUE LATAVIA WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
305 WOODRUN DR, RIDGELAND, MS 39157-2504
(601) 940-5906
Mailing address
305 WOODRUN DR, RIDGELAND, MS 39157-2504
(601) 940-5906
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA8124
MS
Other
Enumeration date
03/24/2026
Last updated
03/24/2026
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