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General NPI Number Information
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NPI Number | 1992973143
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Entity Type | Individual
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Provider Name | MICHELLE ELIZABETH WILLIAMS O.T.
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Gender | Female
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Dates
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Enumeration Date | 02/11/2008
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Last Update Date | 06/13/2022
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Provider Practice Location Address
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Address Line | 150 SOUTHPARK BLVD STE 202
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32086-5179
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Country | US
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Telephone | 904-217-3103
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Fax | 904-467-3422
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Provider Business Mailing Address
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Address Line | 2005 MARIPOSA VISTA LN APT 207
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32084-0682
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Country | US
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Telephone | 215-805-1307
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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 | OT20773
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License Number State | FL
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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 | OT 4671
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License Number State | CA
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