Provider Demographics
NPI:1396188868
Name:WILLIAMS, AMY CATHERINE (DPT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:CATHERINE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:CATHERINE
Other - Last Name:MCCULLOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:753 BOSTON POST RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2749
Mailing Address - Country:US
Mailing Address - Phone:203-458-6268
Mailing Address - Fax:203-458-9230
Practice Address - Street 1:753 BOSTON POST RD
Practice Address - Street 2:SUITE 101
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2749
Practice Address - Country:US
Practice Address - Phone:203-458-6268
Practice Address - Fax:203-458-9230
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009454225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist