Provider Demographics
NPI:1235400987
Name:WILLIAMSON, SARA SHARI (MOTR/L, CLT)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:SHARI
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:MOTR/L, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 ROAD 1
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-9790
Mailing Address - Country:US
Mailing Address - Phone:662-816-7797
Mailing Address - Fax:
Practice Address - Street 1:618 ROAD 1
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-9790
Practice Address - Country:US
Practice Address - Phone:662-816-7797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2022-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR274913225X00000X
ME2531225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist