Provider Demographics
| NPI: | 1003149832 |
|---|---|
| Name: | DAVIS, TRISEL MICHELLE (MOT, OTR) |
| Entity Type: | Individual |
| Prefix: | |
| First Name: | TRISEL |
| Middle Name: | MICHELLE |
| Last Name: | DAVIS |
| Suffix: | |
| Gender: | F |
| Credentials: | MOT, OTR |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 6802 LOST TIMBER LN |
| Mailing Address - Street 2: | |
| Mailing Address - City: | RICHMOND |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77469-4471 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 281-725-0062 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 6802 LOST TIMBER LN |
| Practice Address - Street 2: | |
| Practice Address - City: | RICHMOND |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77469-4471 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 281-725-0062 |
| Practice Address - Fax: | |
| Is Sole Proprietor?: | Yes |
| Enumeration Date: | 2009-09-11 |
| Last Update Date: | 2009-09-12 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| TX | 103432 | 225X00000X, 225XE0001X, 225XF0002X, 225XH1300X, 225XL0004X, 225XM0800X, 225XP0200X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | |
| No | 225XE0001X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Environmental Modification |
| No | 225XF0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Feeding, Eating & Swallowing |
| No | 225XH1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Human Factors |
| No | 225XL0004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Low Vision |
| No | 225XM0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Mental Health |
| No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
