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Individual

CARLA RENA KERSEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
266 KIDD ST, FORT WALTON BEACH, FL 32548-4478
(850) 582-2689
(850) 244-0971
Mailing address
266 KIDD ST, FORT WALTON BEACH, FL 32548-4478
(850) 582-2689
(850) 244-0971

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT0001047
FL
225XP0200X
Pediatric Occupational Therapist
OT1047
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002115800
FL
05
103169100
FL
05
880450800
FL
05
88045088
FL
Enumeration date
07/18/2006
Last updated
10/14/2021
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