Provider Demographics
NPI:1790006575
Name:O'CONNELL, KERRI LYNN (OTR/L)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:LYNN
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:LYNN
Other - Last Name:SANTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:614 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-3548
Mailing Address - Country:US
Mailing Address - Phone:401-871-0118
Mailing Address - Fax:
Practice Address - Street 1:614 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-3548
Practice Address - Country:US
Practice Address - Phone:401-871-0118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9139225X00000X
RIOT01222225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist