Provider Demographics
NPI:1821230020
Name:NEWSOM, ANNETTE KESSLER (OTR)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:KESSLER
Last Name:NEWSOM
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:SUZANNE
Other - Last Name:KESSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:2222 SULLIVAN TRL
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-7958
Mailing Address - Country:US
Mailing Address - Phone:800-944-9782
Mailing Address - Fax:610-438-2024
Practice Address - Street 1:1310 S FRIENDSWOOD DR
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-4968
Practice Address - Country:US
Practice Address - Phone:281-993-5209
Practice Address - Fax:281-993-5209
Is Sole Proprietor?:No
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111337225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist