Provider Demographics
NPI:1831395664
Name:KERR, REBECCA NICOLE (BS)
Entity type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:NICOLE
Last Name:KERR
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 FOX RUN DR
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1032
Mailing Address - Country:US
Mailing Address - Phone:601-264-4669
Mailing Address - Fax:
Practice Address - Street 1:2020 HARDY ST
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-4941
Practice Address - Country:US
Practice Address - Phone:601-544-8556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor