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General NPI Number Information
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NPI Number | 1083820823
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Entity Type | Individual
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Provider Name | DIANA WILLIAMS OTR/CHT
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 10/26/2011
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Provider Practice Location Address
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Address Line | 3708 NORTHSIDE DR
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City | MACON
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State | GA
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Zip | 31210-2404
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Country | US
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Telephone | 478-750-2801
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Fax | 478-750-6626
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Provider Business Mailing Address
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Address Line | 3708 NORTHSIDE DR
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City | MACON
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State | GA
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Zip | 31210-2404
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Country | US
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Telephone | 478-750-2801
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Fax | 478-750-6626
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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 | OT002582
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License Number State | GA
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