Provider Demographics
NPI:1326510645
Name:KERR, BRANDON D
Entity Type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:D
Last Name:KERR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2234 ROBERT ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-2963
Mailing Address - Country:US
Mailing Address - Phone:724-689-3222
Mailing Address - Fax:
Practice Address - Street 1:1000 MAPLEWOOD DR
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-9115
Practice Address - Country:US
Practice Address - Phone:304-933-3338
Practice Address - Fax:304-933-3339
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPSLP-0784235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist