Provider Demographics
NPI:1598783284
Name:MORGAN, KERRI A (OT)
Entity Type:Individual
Prefix:MS
First Name:KERRI
Middle Name:A
Last Name:MORGAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4444 FOREST PARK AVE
Mailing Address - Street 2:C B 8505
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2212
Mailing Address - Country:US
Mailing Address - Phone:314-286-1669
Mailing Address - Fax:314-286-1601
Practice Address - Street 1:4444 FOREST PARK AVE STE 2210
Practice Address - Street 2:STE 2210
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2212
Practice Address - Country:US
Practice Address - Phone:314-286-1669
Practice Address - Fax:314-289-6131
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005347225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000021848Medicare PIN
MO000021848Medicaid