Provider Demographics
NPI:1851358089
Name:WILLIAMSON, DEBRA FOGELMAN (PT)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:FOGELMAN
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:FOGELMAN
Other - Last Name:WOODALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 SAINT VINCENT CIR
Mailing Address - Street 2:STE 100
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5412
Mailing Address - Country:US
Mailing Address - Phone:501-663-6455
Mailing Address - Fax:501-663-4877
Practice Address - Street 1:5 SAINT VINCENT CIR
Practice Address - Street 2:STE 100
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5412
Practice Address - Country:US
Practice Address - Phone:501-663-6455
Practice Address - Fax:501-663-4877
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR18182251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic