Provider Demographics
NPI:1255698528
Name:CHIARALUCE, KERRI ANN (OTR/L)
Entity type:Individual
Prefix:
First Name:KERRI ANN
Middle Name:
Last Name:CHIARALUCE
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 1:19 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02571-1442
Mailing Address - Country:US
Mailing Address - Phone:508-291-4024
Mailing Address - Fax:
Practice Address - Street 1:19 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571-1442
Practice Address - Country:US
Practice Address - Phone:508-291-4024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8945225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist