Provider Demographics
NPI:1104023548
Name:DUES, KERRI (OTR)
Entity Type:Individual
Prefix:MISS
First Name:KERRI
Middle Name:
Last Name:DUES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:
Other - Last Name:HARDIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:478 PONDEROSA DR
Mailing Address - Street 2:
Mailing Address - City:PAINTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41240-8558
Mailing Address - Country:US
Mailing Address - Phone:606-367-6885
Mailing Address - Fax:
Practice Address - Street 1:571 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:SALYERSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41465-9248
Practice Address - Country:US
Practice Address - Phone:606-349-6182
Practice Address - Fax:606-349-5962
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKYR3426225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist