Healthcare Provider Details

I. General information

NPI: 1144148479
Provider Name (Legal Business Name): MARIAH WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 ROSS DR
STOW OH
44224-2742
US

IV. Provider business mailing address

2221 ROSS DR
STOW OH
44224-2742
US

V. Phone/Fax

Practice location:
  • Phone: 330-786-5972
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number467461
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number103166
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: