Provider Demographics
NPI:1851973655
Name:WILLIAMS, HARLEY (OT R/L)
Entity Type:Individual
Prefix:
First Name:HARLEY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:OT R/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 AUTUMN SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8272
Mailing Address - Country:US
Mailing Address - Phone:615-614-8833
Mailing Address - Fax:615-614-8811
Practice Address - Street 1:2214 E FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-2860
Practice Address - Country:US
Practice Address - Phone:423-928-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6808225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics