Provider Demographics
NPI:1548963317
Name:TRESSLER, ELIZABETH MARIE (COTA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARIE
Last Name:TRESSLER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:MARIE
Other - Last Name:TRESSLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA
Mailing Address - Street 1:12870 COUNTY ROAD 110
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-5186
Mailing Address - Country:US
Mailing Address - Phone:417-439-5708
Mailing Address - Fax:
Practice Address - Street 1:12870 COUNTY ROAD 110
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-5186
Practice Address - Country:US
Practice Address - Phone:417-439-5708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015044722224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant