Provider Demographics
NPI:1073775789
Name:SEXTON, KERRY R
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:R
Last Name:SEXTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 KENDARBREN DR
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1064
Mailing Address - Country:US
Mailing Address - Phone:215-489-8760
Mailing Address - Fax:
Practice Address - Street 1:1780 KENDARBREN DR
Practice Address - Street 2:
Practice Address - City:JAMISON
Practice Address - State:PA
Practice Address - Zip Code:18929-1064
Practice Address - Country:US
Practice Address - Phone:215-489-8760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist