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General NPI Number Information
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NPI Number | 1821805656
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Entity Type | Individual
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Provider Name | LAURA JANE WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 10240 BROADWAY EXT
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City | OKLAHOMA CITY
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State | OK
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Zip | 73114-6309
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Country | US
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Telephone | 405-900-8850
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Fax |
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Provider Business Mailing Address
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Address Line | 75 W HIGHWAY 312
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City | KEAVY
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State | KY
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Zip | 40737-4400
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Country | US
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Telephone |
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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 | 5984
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License Number State | OK
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