Provider Demographics
NPI:1093826448
Name:CARVER, TRISHA ANN (MSOT)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:ANN
Last Name:CARVER
Suffix:
Gender:F
Credentials:MSOT
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:
Other - Last Name:BEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOT
Mailing Address - Street 1:257 PATTON LN
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-8618
Mailing Address - Country:US
Mailing Address - Phone:865-354-8861
Mailing Address - Fax:
Practice Address - Street 1:257 PATTON LN
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-8618
Practice Address - Country:US
Practice Address - Phone:865-354-8861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2944225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5440803Medicaid
TN4130431OtherBCBS