| Doctor Name: | KERRY A EBERT |
| NPI Number: | 1649439936 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | OT |
| License Number: | 01170 |
| Business Practice Address: | 2 Dudley St Suite 200 Providence, RI - 029053236 |
| Business Phone Number: | 4014571580 |
| Business Fax Number: | 4018310500 |
| Mailing Address: | Po Box 1119, PROVIDENCE |
| State: | RI |
| Postal Code: | 029011119 |
| Phone Number: | 4014571580 |
| Fax Number: | 4018310500 |
| NPI Enumeration Date: | 06/03/2008 |
| NPI Last Update Date: | 08/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 01170 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |