Individual
MRS. KERRY ANNE NISSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
2049 ROCKY STREAM RD, YORK, SC 29745-6611
(615) 456-5391
(888) 770-7861
Mailing address
2049 ROCKY STREAM RD, YORK, SC 29745-6611
(615) 456-5391
(888) 770-7861
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3641
SC
Other
Enumeration date
01/03/2007
Last updated
11/17/2010
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