Provider Demographics
NPI:1962377838
Name:WILLIAMS, BETTY KANEE
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:KANEE
Last Name:WILLIAMS
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 E MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-6030
Mailing Address - Country:US
Mailing Address - Phone:405-857-8280
Mailing Address - Fax:
Practice Address - Street 1:2121 E MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-6030
Practice Address - Country:US
Practice Address - Phone:405-857-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1680224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant