Healthcare Provider Details

I. General information

NPI: 1083995575
Provider Name (Legal Business Name): KERRI LINDA HORGAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2011
Last Update Date: 08/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 PARK DR
WESTFORD MA
01886-3511
US

IV. Provider business mailing address

109 CASPIAN WAY
FITCHBURG MA
01420-8933
US

V. Phone/Fax

Practice location:
  • Phone: 978-392-1144
  • Fax:
Mailing address:
  • Phone: 978-201-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number7614
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: