Provider Demographics
NPI:1467092411
Name:WILLIAMS, EMMA LYNN (COTA/L)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 THORNY BUSH LN
Mailing Address - Street 2:
Mailing Address - City:WARFORDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17267-8466
Mailing Address - Country:US
Mailing Address - Phone:240-382-0200
Mailing Address - Fax:
Practice Address - Street 1:2101 DEYERLE AVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8025
Practice Address - Country:US
Practice Address - Phone:540-574-2982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131002272224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant