Individual
MRS. JACINTA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1900 HIGHWAY 71, SPIRIT LAKE, IA 51360-1097
(712) 336-3797
Mailing address
1650 TRI PARK WAY, APPLETON, WI 54914-1652
(920) 830-6697
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
00131
IA
224Z00000X
Occupational Therapy Assistant
201724
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00131
COTA LICENSE
IA
01
—
201724
COTA LICENSE
MN
Enumeration date
10/02/2014
Last updated
10/02/2014
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