Basic Information
| Provider Information | |||||||||
| NPI: | 1053698431 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | OTC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22 SUN POND LANE | ||||||||
| Address2: | |||||||||
| City: | NEW MILFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06776 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8609453012 | ||||||||
| FaxNumber: | 8609459854 | ||||||||
| Practice Location | |||||||||
| Address1: | 22 SUN POND LN | ||||||||
| Address2: | |||||||||
| City: | NEW MILFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 067763987 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8609453012 | ||||||||
| FaxNumber: | 8609459854 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2011 | ||||||||
| LastUpdateDate: | 11/14/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 003440 | CT | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.