Provider Demographics
NPI:1053671560
Name:WILLIAMS, SHANTEL (HHA)
Entity type:Individual
Prefix:
First Name:SHANTEL
Middle Name:
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 1:1503 TANNER ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-2909
Mailing Address - Country:US
Mailing Address - Phone:202-257-5632
Mailing Address - Fax:
Practice Address - Street 1:1503 TANNER ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2909
Practice Address - Country:US
Practice Address - Phone:202-257-5632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider