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General NPI Number Information
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NPI Number | 1962229930
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Entity Type | Individual
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Provider Name | SHELBY WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 09/23/2024
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 1075 WASHINGTON BLVD
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City | ROBBINSVILLE
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State | NJ
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Zip | 08691-3119
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Country | US
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Telephone | 609-900-2610
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Fax |
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Provider Business Mailing Address
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Address Line | 12 BETH DR
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City | MOORESTOWN
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State | NJ
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Zip | 08057-3022
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Country | US
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Telephone | 856-304-2308
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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 | 2081P0010X
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Taxonomy Name | Pediatric Rehabilitation Medicine Physician
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License Number | 46TR01200000
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License Number State | NJ
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