Provider Demographics
NPI:1104340108
Name:KERR, MARITZA (SPED TR)
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:KERR
Suffix:
Gender:F
Credentials:SPED TR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 VERMONT ST # 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-2513
Mailing Address - Country:US
Mailing Address - Phone:347-272-4181
Mailing Address - Fax:
Practice Address - Street 1:74 VERMONT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-2513
Practice Address - Country:US
Practice Address - Phone:347-272-4181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103K00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst