Provider Demographics
NPI:1235618950
Name:WILLIAMS, RALEESHA JOVANNA
Entity type:Individual
Prefix:
First Name:RALEESHA
Middle Name:JOVANNA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 E 51ST ST APT 220
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-3654
Mailing Address - Country:US
Mailing Address - Phone:918-330-7906
Mailing Address - Fax:
Practice Address - Street 1:4105 E 51ST ST APT 220
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3654
Practice Address - Country:US
Practice Address - Phone:918-330-7906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-13
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator