Healthcare Provider Details

I. General information

NPI: 1316645419
Provider Name (Legal Business Name): ERIN KENNEY BORDEN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN KENNEY OTR/L

II. Dates (important events)

Enumeration Date: 02/17/2023
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 MAIN ST W STE C
HARTSELLE AL
35640-2414
US

IV. Provider business mailing address

1698 PARKER RD SE
HARTSELLE AL
35640-3358
US

V. Phone/Fax

Practice location:
  • Phone: 256-502-5116
  • Fax:
Mailing address:
  • Phone: 256-566-4831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number6018
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: