Organization
BRENTOM, LLC,
Active
Other names
SHARKKS Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAWN MAURICE WILLIAMS MS, OTR/L (OCCUPATIONAL THERAPIST/ OWNER)
(602) 430-8665
Entity
Organization
Contact information
Practice address
20783 N 83RD AVE STE 103, PEORIA, AZ 85382-7430
(623) 444-8880
(623) 444-9282
Mailing address
20783 N 83RD AVE STE 103, PEORIA, AZ 85382-7430
(623) 444-8880
(623) 444-9282
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
2491
AZ
225X00000X
Occupational Therapist
—
—
225XH1200X
Hand Occupational Therapist
2491
AZ
225XM0800X
Mental Health Occupational Therapist
2491
AZ
225XP0019X
Physical Rehabilitation Occupational Therapist
2491
AZ
225XP0200X
Pediatric Occupational Therapist
2491
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
501032
—
AZ
Enumeration date
04/03/2017
Last updated
03/21/2025
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