Provider Demographics
NPI:1902239577
Name:BRYANT, KERRI LOUISE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:LOUISE
Last Name:BRYANT
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MISS
Other - First Name:KERRI
Other - Middle Name:LOUISE
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:17 OUTER DR
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-4057
Mailing Address - Country:US
Mailing Address - Phone:865-803-2180
Mailing Address - Fax:
Practice Address - Street 1:120 CAVETTE HILL LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-6673
Practice Address - Country:US
Practice Address - Phone:865-777-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-18
Last Update Date:2013-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2274224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant