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NPI 1053698431

NPI 1053698431 : DEBORAH S WILLIAMS OTC : NEW MILFORD, CT

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General NPI Number Information
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    NPI Number           |    1053698431
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    Entity Type          |    Individual 
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    Provider Name        |    DEBORAH S WILLIAMS OTC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/14/2011
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    Last Update Date     |    11/14/2011
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Provider Practice Location Address
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    Address Line         |    22 SUN POND LN 
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    City                 |    NEW MILFORD
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    State                |    CT
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    Zip                  |    06776-3987
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    Country              |    US
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    Telephone            |    860-945-3012
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    Fax                  |    860-945-9854
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Provider Business Mailing Address
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    Address Line         |    22 SUN POND LANE 
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    City                 |    NEW MILFORD
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    State                |    CT
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    Zip                  |    06776
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    Country              |    US
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    Telephone            |    860-945-3012
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    Fax                  |    860-945-9854
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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        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    003440
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    License Number State |    CT
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