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General NPI Number Information
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NPI Number | 1235024613
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Entity Type | Individual
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Provider Name | CARLESHA CELESTE WILLIAMS OTA
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Gender | Female
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 2401 NW 23RD ST STE C
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City | OKLAHOMA CITY
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State | OK
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Zip | 73107-2442
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Country | US
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Telephone | 405-355-3239
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Fax |
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Provider Business Mailing Address
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Address Line | 14209 GLEN OAKS PL
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City | EDMOND
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State | OK
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Zip | 73013-2434
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Country | US
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Telephone | 57-778-0478
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Fax |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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