Provider Demographics
NPI:1457567927
Name:KERR, GERALDINE M (EDS)
Entity Type:Individual
Prefix:MS
First Name:GERALDINE
Middle Name:M
Last Name:KERR
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 MOUNTAIN AVE
Mailing Address - Street 2:SUITE 4A
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2407
Mailing Address - Country:US
Mailing Address - Phone:908-813-8232
Mailing Address - Fax:908-813-8866
Practice Address - Street 1:254 MOUNTAIN AVE
Practice Address - Street 2:SUITE 4A
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2407
Practice Address - Country:US
Practice Address - Phone:908-813-8232
Practice Address - Fax:908-813-8866
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJF101190106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist