Provider Demographics
NPI:1861208845
Name:WILLIAMS, RAPHAELA DENISE
Entity type:Individual
Prefix:MRS
First Name:RAPHAELA
Middle Name:DENISE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 AZALEA TRL
Mailing Address - Street 2:
Mailing Address - City:SYLVESTER
Mailing Address - State:GA
Mailing Address - Zip Code:31791-1421
Mailing Address - Country:US
Mailing Address - Phone:229-206-7919
Mailing Address - Fax:
Practice Address - Street 1:203 AZALEA TRL
Practice Address - Street 2:
Practice Address - City:SYLVESTER
Practice Address - State:GA
Practice Address - Zip Code:31791-1421
Practice Address - Country:US
Practice Address - Phone:229-206-7919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor