Provider Demographics
NPI:1003045584
Name:REID, TRISHA (PT ASST)
Entity Type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:
Last Name:REID
Suffix:
Gender:F
Credentials:PT ASST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 MULBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-4660
Mailing Address - Country:US
Mailing Address - Phone:407-590-5562
Mailing Address - Fax:321-939-4098
Practice Address - Street 1:613 MULBERRY AVE
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-4660
Practice Address - Country:US
Practice Address - Phone:407-590-5562
Practice Address - Fax:321-939-4098
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16315225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant