Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 006477 | GA |
NPI | 1013146232 |
---|---|
Provider Name | Mrs. Erinn Schleicher Williams |
First Address | Decatur, GA 30030-4551 |
Second Address | Lawrenceville, GA 30043-7986 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2009 |
Last Update Date | 09/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000856677A | (05) | GA |