Provider Demographics
NPI:1598736084
Name:ROBERSON, KERRY ANNE (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:ANNE
Last Name:ROBERSON
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:MS
Other - First Name:KERRY
Other - Middle Name:ANNE
Other - Last Name:GALLANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:PSC 556 BOX 363
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96386-0363
Mailing Address - Country:US
Mailing Address - Phone:0118198-933-2335
Mailing Address - Fax:
Practice Address - Street 1:US NAVAL HOSPITAL OKINAWA JAPAN
Practice Address - Street 2:PSC 482 BOX 1600
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96362-1600
Practice Address - Country:JP
Practice Address - Phone:01181611-743-7400
Practice Address - Fax:01181611-743-0228
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013002-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist