Provider Demographics
NPI:1184164220
Name:WILLIAMS, SARAH JANE (COTA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
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 1:424 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:KS
Mailing Address - Zip Code:66067-2112
Mailing Address - Country:US
Mailing Address - Phone:785-418-4204
Mailing Address - Fax:
Practice Address - Street 1:1501 INVERNESS DR
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-1870
Practice Address - Country:US
Practice Address - Phone:785-838-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-07
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-01378224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant