Provider Demographics
NPI:1053552729
Name:WILLIAMS, ENTILINA DENIAHE (HHA)
Entity type:Individual
Prefix:MS
First Name:ENTILINA
Middle Name:DENIAHE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12123 SANTA ROSA DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48204-5321
Mailing Address - Country:US
Mailing Address - Phone:313-350-9972
Mailing Address - Fax:
Practice Address - Street 1:12123 SANTA ROSA DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48204-5321
Practice Address - Country:US
Practice Address - Phone:313-350-9972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications