Hallianda Marie Williams, LMT.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

170836 Issued in KY

Practice address

10701 W Manslick Rd
Fairdale, KY 40118-9581

Phone

(502) 367-2112

Fax

(502) 367-7799

NPI assigned

Apr 3, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Hallianda Marie Gonzalez Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1437681822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 W. MANSLICK RD.",
            "city": "FAIRDALE",
            "state": "KY",
            "postal_code": "40118",
            "telephone_number": "502-367-2112",
            "fax_number": "502-367-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 W MANSLICK RD",
            "city": "FAIRDALE",
            "state": "KY",
            "postal_code": "401189581",
            "telephone_number": "502-367-2112",
            "fax_number": "502-367-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "HALLIANDA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "LMT.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "KY",
            "license": "170836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALLIANDA",
            "last_name": "GONZALEZ",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "LMT.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Massage Therapist in Fairdale, KY
• Providers in Fairdale, KY by specialty
• Massage Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.