Provider Demographics
NPI:1669897625
Name:BURRIS, KARI MARIE RUDDUCK (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:MARIE RUDDUCK
Last Name:BURRIS
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:MARIE
Other - Last Name:RUDDUCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT, OTR/L
Mailing Address - Street 1:1879 DEERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-8602
Mailing Address - Country:US
Mailing Address - Phone:513-695-2900
Mailing Address - Fax:
Practice Address - Street 1:1879 DEERFIELD RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-8602
Practice Address - Country:US
Practice Address - Phone:513-695-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH008008225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics