Basic Information
| Provider Information | |||||||||
| NPI: | 1811219983 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KERR | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | JEAN | ||||||||
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| Credential: | MSC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 789 CENTRAL AVENUE | ||||||||
| Address2: | BUSINESS OFFICE | ||||||||
| City: | DOVER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038202526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037404478 | ||||||||
| FaxNumber: | 6037402244 | ||||||||
| Practice Location | |||||||||
| Address1: | 17 OLD ROLLINSFORD ROAD | ||||||||
| Address2: | SUITE 6 | ||||||||
| City: | DOVER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038202833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035160092 | ||||||||
| FaxNumber: | 6035160093 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2010 | ||||||||
| LastUpdateDate: | 02/17/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 170300000X | 12475 | ZZ | Y | Other Service Providers | Genetic Counselor, MS |
No ID Information.