Provider Demographics
NPI:1992867394
Name:WILLIAMS, KELLY ANN (COTA)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001
Mailing Address - Country:US
Mailing Address - Phone:530-244-4077
Mailing Address - Fax:
Practice Address - Street 1:2490 COURT ST
Practice Address - Street 2:REDDING CARE CENTER
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2540
Practice Address - Country:US
Practice Address - Phone:530-246-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant