Provider Demographics
NPI:1760857122
Name:KERRIGAN, DEBRA (OTR/L)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:KERRIGAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:HOLLISTON
Mailing Address - State:MA
Mailing Address - Zip Code:01746-1663
Mailing Address - Country:US
Mailing Address - Phone:508-245-2782
Mailing Address - Fax:
Practice Address - Street 1:190 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:HOLLISTON
Practice Address - State:MA
Practice Address - Zip Code:01746-1663
Practice Address - Country:US
Practice Address - Phone:508-245-2782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8239225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist