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General NPI Number Information
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NPI Number | 1710650023
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Entity Type | Individual
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Provider Name | CYNTHIA CHAITAH WILLIAMS LMT, ESTHETICIAN
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Gender | Female
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Dates
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Enumeration Date | 08/01/2021
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Last Update Date | 08/01/2021
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Provider Practice Location Address
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Address Line | 2800 N 9TH AVE APT 30B
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City | PENSACOLA
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State | FL
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Zip | 32503-3694
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Country | US
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Telephone | 850-208-8253
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Fax |
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Provider Business Mailing Address
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Address Line | 707 E CERVANTES ST # B228
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City | PENSACOLA
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State | FL
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Zip | 32501-3286
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Country | US
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Telephone | 850-208-8253
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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 | MA66988
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License Number State | FL
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