Provider Demographics
NPI:1114517364
Name:WILLIAMS, HEATHER MAY (OTA)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MAY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16131 E 85TH ST N
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-8410
Mailing Address - Country:US
Mailing Address - Phone:918-986-6448
Mailing Address - Fax:
Practice Address - Street 1:16131 E 85TH ST N
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-8410
Practice Address - Country:US
Practice Address - Phone:918-986-6448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1766224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant