=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437729357
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KERRI LYNNE REID BRIDENHAGEN OTR/L, CHT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/01/2021
-----------------------------------------------------
Last Update Date | 03/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 159 WELLS AVE STE 500
-----------------------------------------------------
City | NEWTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02459-3301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-965-4263
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25 2ND ST APT 402
-----------------------------------------------------
City | CHELSEA
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02150-4643
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-345-1839
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 14028
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225XH1200X
-----------------------------------------------------
Taxonomy Name | Hand Occupational Therapist
-----------------------------------------------------
License Number | 14028
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------