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General NPI Number Information
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NPI Number | 1396086989
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Entity Type | Individual
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Provider Name | ASHLEY WILLIAMSON DECKERS MOT, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/07/2013
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Last Update Date | 01/31/2014
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Provider Practice Location Address
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Address Line | 1386 S RIDGE LAKE CIR
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City | LONGWOOD
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State | FL
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Zip | 32750-2876
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Country | US
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Telephone | 407-461-3705
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Fax |
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Provider Business Mailing Address
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Address Line | 1386 S RIDGE LAKE CIR
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City | LONGWOOD
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State | FL
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Zip | 32750-2876
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Country | US
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Telephone | 407-461-3705
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT15588
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License Number State | FL
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