Provider Demographics
NPI:1033748215
Name:COTTLE, KERRY ANN (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:KERRY
Middle Name:ANN
Last Name:COTTLE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:NH
Mailing Address - Zip Code:03773-1429
Mailing Address - Country:US
Mailing Address - Phone:603-863-3710
Mailing Address - Fax:
Practice Address - Street 1:21 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:NH
Practice Address - Zip Code:03773-1429
Practice Address - Country:US
Practice Address - Phone:603-863-3710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2654225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2654OtherSTATE OF NH OFFICE OF ALLIED HEALTH PROFESSIONALS
380995OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY