Provider Demographics
NPI:1225487796
Name:WILLIAMS, KATIE (OT/L)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 E 116TH ST APT 1C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-1308
Mailing Address - Country:US
Mailing Address - Phone:208-339-5283
Mailing Address - Fax:
Practice Address - Street 1:10 FURMAN CT
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-1611
Practice Address - Country:US
Practice Address - Phone:208-339-5283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1-0012463225XP0200X
NY020248225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics