Provider Demographics
NPI:1801063276
Name:WILLIAMSON, KRISTEN N (OT)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:N
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32915 DITTMAN HILL RD
Mailing Address - Street 2:
Mailing Address - City:WAUZEKA
Mailing Address - State:WI
Mailing Address - Zip Code:53826-8602
Mailing Address - Country:US
Mailing Address - Phone:608-306-1083
Mailing Address - Fax:
Practice Address - Street 1:101 SUNSHINE BLVD
Practice Address - Street 2:
Practice Address - City:SOLDIERS GROVE
Practice Address - State:WI
Practice Address - Zip Code:54655-7106
Practice Address - Country:US
Practice Address - Phone:608-624-5244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1876-027225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist