Basic Information
| Provider Information | |||||||||
| NPI: | 1801063276 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WILLIAMSON | ||||||||
| FirstName: | KRISTEN | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | OT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 32915 DITTMAN HILL RD | ||||||||
| Address2: | |||||||||
| City: | WAUZEKA | ||||||||
| State: | WI | ||||||||
| PostalCode: | 538268602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6083061083 | ||||||||
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| Practice Location | |||||||||
| Address1: | 101 SUNSHINE BLVD | ||||||||
| Address2: | |||||||||
| City: | SOLDIERS GROVE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 546557106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6086245244 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2008 | ||||||||
| LastUpdateDate: | 05/14/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 1876-027 | WI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.