Provider Demographics
NPI:1295822831
Name:WILLIAMS, SHERMISHA SHERVETTE (OT)
Entity Type:Individual
Prefix:
First Name:SHERMISHA
Middle Name:SHERVETTE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P . O. BOX 241
Mailing Address - Street 2:
Mailing Address - City:WARM SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:31830-2418
Mailing Address - Country:US
Mailing Address - Phone:706-655-2418
Mailing Address - Fax:
Practice Address - Street 1:6391 ROOSEVELT HWY
Practice Address - Street 2:ROOSEVELT WARM SPRINGS INSTITUTE FOR REHABILITATION
Practice Address - City:WARM SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:31830
Practice Address - Country:US
Practice Address - Phone:706-655-5738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist