Provider Demographics
NPI:1356175830
Name:WILLIAMS, LAUREN TECCE (PT, DPT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:TECCE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 LANTERN LN
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-2050
Mailing Address - Country:US
Mailing Address - Phone:610-574-1551
Mailing Address - Fax:
Practice Address - Street 1:235 CYPRESS ST STE 110
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-6777
Practice Address - Country:US
Practice Address - Phone:617-860-6430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA27799225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist