Provider Demographics
NPI:1821303918
Name:OSTERGREN, JERRI (OT)
Entity Type:Individual
Prefix:
First Name:JERRI
Middle Name:
Last Name:OSTERGREN
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 1:320 BOWDEN RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-9029
Mailing Address - Country:US
Mailing Address - Phone:919-619-0845
Mailing Address - Fax:
Practice Address - Street 1:3929 BELMONT FOREST WAY
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-4358
Practice Address - Country:US
Practice Address - Phone:919-606-1019
Practice Address - Fax:866-641-2807
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0695225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist