Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OC018008 | PA |
NPI | 1821749201 |
---|---|
Provider Name | Ms. Candace Charisse Williams |
First Address | Easton, PA 18045-5791 |
Second Address | Wind Gap, PA 18091-9683 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2022 |
Last Update Date | 17/01/2022 |