Provider Demographics
NPI:1932220472
Name:KERSHEY, MARY JULIA
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:JULIA
Last Name:KERSHEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6932 GREENLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3713
Mailing Address - Country:US
Mailing Address - Phone:440-882-6803
Mailing Address - Fax:
Practice Address - Street 1:18840 FALLING WATER RD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-4200
Practice Address - Country:US
Practice Address - Phone:440-238-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH005894225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist