Healthcare Provider Details

I. General information

NPI: 1598736084
Provider Name (Legal Business Name): KERRY ANNE ROBERSON MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: KERRY ANNE GALLANT MS, OTR/L

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US NAVAL HOSPITAL OKINAWA JAPAN PSC 482 BOX 1600
FPO AP
96362-1600
JP

IV. Provider business mailing address

PSC 556 BOX 363
FPO AP
96386-0363
US

V. Phone/Fax

Practice location:
  • Phone: 011816117437400
  • Fax: 011816117430228
Mailing address:
  • Phone: 01181989332335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number013002-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: