Provider Demographics
NPI:1134462369
Name:KERR, CARRIE A (MS, CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:A
Last Name:KERR
Suffix:
Gender:F
Credentials:MS, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 SCHOOL STREET
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61571
Mailing Address - Country:US
Mailing Address - Phone:309-745-5413
Mailing Address - Fax:309-745-5413
Practice Address - Street 1:1428 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IL
Practice Address - Zip Code:61571-9509
Practice Address - Country:US
Practice Address - Phone:309-745-5413
Practice Address - Fax:309-745-5413
Is Sole Proprietor?:No
Enumeration Date:2013-04-06
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1467434795235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist