Provider Demographics
NPI:1215299789
Name:SCHWETZ, KERRY ANN (MSED, RBT, QASP)
Entity type:Individual
Prefix:MS
First Name:KERRY
Middle Name:ANN
Last Name:SCHWETZ
Suffix:
Gender:F
Credentials:MSED, RBT, QASP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11265 IRISH MOSS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-1537
Mailing Address - Country:US
Mailing Address - Phone:917-564-4309
Mailing Address - Fax:
Practice Address - Street 1:11265 IRISH MOSS DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-1537
Practice Address - Country:US
Practice Address - Phone:917-564-4309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician