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General NPI Number Information
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NPI Number | 1790875078
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Entity Type | Individual
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Provider Name | SUE ANN WILLIAMS LMT/COTA
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Gender | Female
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Dates
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Enumeration Date | 10/15/2006
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Last Update Date | 01/24/2013
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Provider Practice Location Address
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Address Line | 433 N MAIN ST
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City | WARSAW
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State | NY
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Zip | 14569-1029
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Country | US
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Telephone | 585-727-6480
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Fax |
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Provider Business Mailing Address
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Address Line | 433 NORTH MAIN STREET
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City | WARSAW
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State | NY
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Zip | 14569
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Country | US
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Telephone | 585-727-6480
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Fax | 585-786-2465
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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 | 003716-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 013922-1
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License Number State | NY
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