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Individual

DANIELLE VICTORIA WILLIAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD, LDN

Contact information

Practice address
5900 BOND AVE, CENTREVILLE, IL 62207-2326
(618) 552-5458
(618) 332-5369
Mailing address
10 LILA LN, FLORISSANT, MO 63033-5406
(314) 599-6313

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164007995
IL
133V00000X
Registered Dietitian
2019046996
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
164007995
LISCENSED DIETITIAN- STATE OF ILLINOIS
IL
01
86109984
ACADEMY OF NUTRITION AND DIETETICS REGISTRATION ID NUMBER
Enumeration date
10/22/2020
Last updated
10/22/2020
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