Provider Demographics
NPI:1124616743
Name:KERR, MARIAH ANGEL (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:ANGEL
Last Name:KERR
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1747 ROUTE 68
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:15066-4224
Mailing Address - Country:US
Mailing Address - Phone:724-920-2579
Mailing Address - Fax:
Practice Address - Street 1:810 W 8TH ST
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-2302
Practice Address - Country:US
Practice Address - Phone:330-385-7132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20201580-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist