Individual provider · Type 1 NPI

Dameta Diane Williams, MASTER ESTHETICIAN

Massage Therapist · Fort Wayne, IN

NPI number 1629677604 Active

Practice location

3525 Lake Ave
Fort Wayne, IN 46805-5599

Call (260) 201-2000 Map

Mailing address

478 Greenpointe Pkwy
Fort Wayne, IN 46814-7611

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XNone listed

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1629677604

Dameta Diane Williams, MASTER ESTHETICIAN's National Provider Identifier is 1629677604, issued on Oct 21, 2020. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Fort Wayne, IN. The record was last updated on Oct 21, 2020.