Provider Demographics
NPI:1578789954
Name:WILLIAMS, SHARON RENEE
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:RENEE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9136 CLEVELAND ST
Mailing Address - Street 2:SUITE 2-207
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6916
Mailing Address - Country:US
Mailing Address - Phone:219-472-0545
Mailing Address - Fax:219-472-0246
Practice Address - Street 1:9136 CLEVELAND ST
Practice Address - Street 2:SUITE 2-207
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6916
Practice Address - Country:US
Practice Address - Phone:219-472-0545
Practice Address - Fax:219-472-0246
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist