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General NPI Number Information
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NPI Number | 1356628879
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Entity Type | Individual
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Provider Name | TAMARA NICOLE WILLIAMS-BUTLER LMT, L.AC.
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Gender | Female
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Dates
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Enumeration Date | 11/11/2011
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Last Update Date | 10/09/2014
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Provider Practice Location Address
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Address Line | 540 3RD AVE
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City | SAN DIEGO
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State | CA
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Zip | 92101-6805
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Country | US
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Telephone | 917-324-9887
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Fax |
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Provider Business Mailing Address
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Address Line | 1907 ROBINSON AVE UNIT 307
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City | SAN DIEGO
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State | CA
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Zip | 92104-8200
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Country | US
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Telephone | 917-324-9887
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 10386
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC 15795
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License Number State | CA
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