Provider Demographics
NPI:1306885777
Name:WILLIAMS, DANIELLE E (DOT)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:E
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DOT
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:E
Other - Last Name:KOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DOT
Mailing Address - Street 1:1115 BOULDERS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4067
Mailing Address - Country:US
Mailing Address - Phone:804-560-5595
Mailing Address - Fax:804-560-9029
Practice Address - Street 1:1400 JOHNSTON WILLIS DR
Practice Address - Street 2:SUITE B
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4765
Practice Address - Country:US
Practice Address - Phone:804-379-3840
Practice Address - Fax:804-379-9567
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119004282225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA540885859OtherFOCUS
VA540885859OtherCOMPMANAGEMENT
VA7083811OtherAETNA
VA194769OtherANTHEM CHIP OT
VA010274052Medicaid
VA540885859OtherMULTIPLAN
VA0472640003OtherDMERC-JOHNSTON-WILLIS
VA1387429OtherAETNA HMO
VA194770OtherANTHEM-JOHNSTON-WILLIS
VA1577OtherSH CARENET
VA98999OtherOPTIMA HEALTH
VA98999OtherOPTIMA HEALTH
VA0472640015Medicare NSC
VA0472640003Medicare NSC
VA010617W25Medicare PIN