Provider Demographics
NPI:1629506936
Name:BOYCE, KERI (MOT, OTR/L)
Entity type:Individual
Prefix:MS
First Name:KERI
Middle Name:
Last Name:BOYCE
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:MRS
Other - First Name:KERI
Other - Middle Name:
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT, OTR/L
Mailing Address - Street 1:576 CLARENDON AVE
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-9330
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:109 W SMILEY AVE
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:OH
Practice Address - Zip Code:44875-2112
Practice Address - Country:US
Practice Address - Phone:419-342-2442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2024-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT009735225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH380284OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY (NBCOT)
OHOT009735OtherOHIO OT PT AT BOARD
OHOH3278075OtherOHIO DEPARTMENT OF EDUCATION