Healthcare Provider Details

I. General information

NPI: 1306783857
Provider Name (Legal Business Name): LAURENROSE FAITH KESSLER OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 MEADOW VIEW RD
BRISTOL TN
37620-9535
US

IV. Provider business mailing address

1193 W MOUNTAIN VIEW RD UNIT 303
JOHNSON CITY TN
37604-2130
US

V. Phone/Fax

Practice location:
  • Phone: 423-793-3197
  • Fax:
Mailing address:
  • Phone: 606-802-6356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number8648
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: