Provider Demographics
NPI:1437754678
Name:PHAREZ, KENDALL (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:
Last Name:PHAREZ
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9837 US HIGHWAY 98
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-5855
Mailing Address - Country:US
Mailing Address - Phone:251-517-7787
Mailing Address - Fax:
Practice Address - Street 1:9837 US HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-5855
Practice Address - Country:US
Practice Address - Phone:251-517-7787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist