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General NPI Number Information
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NPI Number | 1639162357
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Entity Type | Individual
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Provider Name | SHAWN M WILLIAMS OT
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Gender | Male
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Dates
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Enumeration Date | 08/29/2005
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 20783 N 83RD AVE STE 103
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City | PEORIA
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State | AZ
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Zip | 85382-7430
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Country | US
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Telephone | 623-444-8880
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Fax | 623-444-9282
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Provider Business Mailing Address
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Address Line | 20783 N 83RD AVE STE 103
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City | PEORIA
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State | AZ
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Zip | 85382-7430
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Country | US
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Telephone | 623-444-8880
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Fax | 623-444-9282
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 2491
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2491
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License Number State | AZ
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