Individual
MARY SARA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, OTR L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103361
MN
225X00000X
Occupational Therapist
4494
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
167861
AETNA
—
01
—
391584408
TRICARE
—
05
—
41041200
—
WI
01
—
434L1WI
BCBS MN
MN
01
—
6406809
MEDICA
—
01
—
641671046996
PREFERRED ONE
—
01
—
HP70878
HEALTH PARTNERS
—
Enumeration date
12/06/2006
Last updated
12/22/2010
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