Provider Demographics
NPI:1497893903
Name:KLEMM-BETTS, KERRY LEIGH (OTR)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:LEIGH
Last Name:KLEMM-BETTS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KERRY
Other - Middle Name:L
Other - Last Name:KLEMM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:766 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-3997
Mailing Address - Country:US
Mailing Address - Phone:828-577-7004
Mailing Address - Fax:
Practice Address - Street 1:107 COLLEGE WALK LANE
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-3539
Practice Address - Country:US
Practice Address - Phone:828-577-7004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2015-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5100225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist