Healthcare Provider Details

I. General information

NPI: 1417876525
Provider Name (Legal Business Name): DYMOND MARTISE WILLIAMS CNA/CMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5133 NATHAN AVE
ASHTABULA OH
44004-6643
US

IV. Provider business mailing address

5133 NATHAN AVE
ASHTABULA OH
44004-6643
US

V. Phone/Fax

Practice location:
  • Phone: 440-841-1025
  • Fax:
Mailing address:
  • Phone: 440-841-1025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number602782260324
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: