Provider Demographics
NPI:1851758403
Name:WILLIAMS, JAMIE T (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:T
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2896 MCMAHAN SAWMILL RD
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-7623
Mailing Address - Country:US
Mailing Address - Phone:865-201-0213
Mailing Address - Fax:
Practice Address - Street 1:2896 MCMAHAN SAWMILL RD
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-7623
Practice Address - Country:US
Practice Address - Phone:865-201-0213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT006362225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003172249AMedicaid