Provider Demographics
NPI:1598351439
Name:WILLIAMS, SUSAN P
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:P
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 1:19 BROOKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-4303
Mailing Address - Country:US
Mailing Address - Phone:857-207-9480
Mailing Address - Fax:508-463-4066
Practice Address - Street 1:19 BROOKWOOD RD
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-4303
Practice Address - Country:US
Practice Address - Phone:857-207-9480
Practice Address - Fax:508-463-4066
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RT47802278E1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278E1000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedEducational