Healthcare Provider Details

I. General information

NPI: 1417495425
Provider Name (Legal Business Name): KERRI SILLS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2690 WEWOKA RD
WATERFORD MI
48328-3259
US

IV. Provider business mailing address

501 N CASS LAKE RD
WATERFORD MI
48328-2307
US

V. Phone/Fax

Practice location:
  • Phone: 248-682-9530
  • Fax: 248-738-4703
Mailing address:
  • Phone: 248-797-9647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number275738
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: