Provider Demographics
NPI:1992246193
Name:KERR, MARY C
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:C
Last Name:KERR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 CHURCH ST
Mailing Address - Street 2:75
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-1725
Mailing Address - Country:US
Mailing Address - Phone:508-933-8991
Mailing Address - Fax:
Practice Address - Street 1:1261 CHURCH ST
Practice Address - Street 2:75
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-1725
Practice Address - Country:US
Practice Address - Phone:508-933-8991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health