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General NPI Number Information
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NPI Number | 1922670942
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Entity Type | Individual
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Provider Name | TABITHA SARAI WILLIAMS LMT,MMP
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Gender | Female
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Dates
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Enumeration Date | 07/11/2021
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Last Update Date | 07/11/2021
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Provider Practice Location Address
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Address Line | 808 PEBBLE CREEK CT
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City | ANTIOCH
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State | TN
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Zip | 37013-3701
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Country | US
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Telephone | 870-551-1326
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Fax |
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Provider Business Mailing Address
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Address Line | 808 PEBBLE CREEK CT
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City | ANTIOCH
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State | TN
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Zip | 37013-1872
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Country | US
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Telephone | 870-551-1326
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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 | 11958
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License Number State | TN
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