Provider Demographics
NPI:1306284013
Name:KERSTETTER, LIZA (MSOTR/L)
Entity type:Individual
Prefix:MRS
First Name:LIZA
Middle Name:
Last Name:KERSTETTER
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 NELSON TER
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17061-2420
Mailing Address - Country:US
Mailing Address - Phone:717-439-2859
Mailing Address - Fax:
Practice Address - Street 1:1901 N 5TH ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17102-1510
Practice Address - Country:US
Practice Address - Phone:717-439-2859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOC012884OtherOT LICENSE