Provider Demographics
NPI:1881830990
Name:WILLIAMS, BRIDGET M (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-2032
Mailing Address - Country:US
Mailing Address - Phone:724-539-8968
Mailing Address - Fax:
Practice Address - Street 1:143 HARTMAN RD
Practice Address - Street 2:SUITE 12, OAKLEY PARK
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-7220
Practice Address - Country:US
Practice Address - Phone:724-836-3116
Practice Address - Fax:724-836-3878
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-18
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC009834225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist