Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Kendra Alexis Deberry, PTA

Individual provider Physical Therapy Assistant · NPI 1104847094

Mr. Kendra Alexis Deberry, PTA is a Physical Therapy Assistant in Olive Branch, Mississippi. Licensed in Mississippi. Registered with an NPI since 2006.

Licensed in
MS
In the registry since
2006
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

5600 Goodman Rd Ste D
Olive Branch, MS 38654-7002
Phone: (662) 895-5454
Fax: (662) 895-4546
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PA2517 (MS)

Record details

NPI number1104847094
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedJuly 23, 2006
Last updated in NPPESJuly 8, 2007

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