Provider Demographics
NPI:1043534266
Name:SPECK, KERRI ANN (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:ANN
Last Name:SPECK
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 WESTFORD RD
Mailing Address - Street 2:#23
Mailing Address - City:AYER
Mailing Address - State:MA
Mailing Address - Zip Code:01432-1521
Mailing Address - Country:US
Mailing Address - Phone:978-391-4249
Mailing Address - Fax:
Practice Address - Street 1:484 MAIN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1893
Practice Address - Country:US
Practice Address - Phone:800-244-2756
Practice Address - Fax:508-831-9768
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8253225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist