Provider Demographics
NPI:1245554229
Name:KERN, CAROL J (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:J
Last Name:KERN
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 1:16350 LAKESHORE TERRACE CT
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63038-2310
Mailing Address - Country:US
Mailing Address - Phone:636-394-4766
Mailing Address - Fax:
Practice Address - Street 1:16350 LAKESHORE TERRACE CT
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:MO
Practice Address - Zip Code:63038-2310
Practice Address - Country:US
Practice Address - Phone:636-394-4766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-20
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist