Provider Demographics
NPI:1316425291
Name:DEFREEST, KARI JANECE (OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:JANECE
Last Name:DEFREEST
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:JANECE
Other - Last Name:ROOSENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L, CHT
Mailing Address - Street 1:PO BOX 240101
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:AK
Mailing Address - Zip Code:99824-0101
Mailing Address - Country:US
Mailing Address - Phone:907-821-1953
Mailing Address - Fax:
Practice Address - Street 1:222 TONGASS DR
Practice Address - Street 2:
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835-9416
Practice Address - Country:US
Practice Address - Phone:907-966-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2074225XH1200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand