Provider Demographics
NPI:1154882199
Name:MEIER, TRISHA ANN (COTAL)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:ANN
Last Name:MEIER
Suffix:
Gender:F
Credentials:COTAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3183 HIGHLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:GLADWIN
Mailing Address - State:MI
Mailing Address - Zip Code:48624-9212
Mailing Address - Country:US
Mailing Address - Phone:989-578-2426
Mailing Address - Fax:
Practice Address - Street 1:3270 PRATT LAKE RD
Practice Address - Street 2:
Practice Address - City:GLADWIN
Practice Address - State:MI
Practice Address - Zip Code:48624-8901
Practice Address - Country:US
Practice Address - Phone:989-426-7275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-30
Last Update Date:2019-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5202006202224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant