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Individual

MS. MARISSA KERN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
3851 COMMERCIAL CENTER DR, LADSON, SC 29456-4146
(843) 314-5434
Mailing address
3851 COMMERCIAL CENTER DR, LADSON, SC 29456-4146
(843) 314-5434

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
024962
NY
225X00000X
Occupational Therapist
Primary
7005
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
TH5493
SC
Enumeration date
09/15/2020
Last updated
12/12/2023
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