Provider Demographics
NPI:1154825222
Name:LERNER, KATHLEEN SARAH (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:SARAH
Last Name:LERNER
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 1:5150 NET DR APT 4303
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-5062
Mailing Address - Country:US
Mailing Address - Phone:813-765-7752
Mailing Address - Fax:
Practice Address - Street 1:5150 NET DR APT 4303
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-5062
Practice Address - Country:US
Practice Address - Phone:813-765-7752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19038225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist