Provider Demographics
NPI:1871483479
Name:WILLIAMS, SHALIKA CHANAE (LMT)
Entity type:Individual
Prefix:
First Name:SHALIKA
Middle Name:CHANAE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:XTRODINARY
Other - Middle Name:
Other - Last Name:TOUCHE LLC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:9 DALLAS ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:GA
Mailing Address - Zip Code:31816-1704
Mailing Address - Country:US
Mailing Address - Phone:706-672-7793
Mailing Address - Fax:
Practice Address - Street 1:9 DALLAS ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:GA
Practice Address - Zip Code:31816-1704
Practice Address - Country:US
Practice Address - Phone:706-672-7793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA93928225700000X
GAMT014195225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist