Provider Demographics
NPI:1992142038
Name:WILLIAMS, BARBARA LEIGH (COTA/L)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:LEIGH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14414
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27620-4414
Mailing Address - Country:US
Mailing Address - Phone:205-441-6367
Mailing Address - Fax:
Practice Address - Street 1:1821 EVA MAE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-4450
Practice Address - Country:US
Practice Address - Phone:205-441-6367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8696224Z00000X
AL8020224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant