Provider Demographics
NPI:1376947895
Name:PEARCE, LATRESHA (OTR/L)
Entity Type:Individual
Prefix:
First Name:LATRESHA
Middle Name:
Last Name:PEARCE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7902 NW 36TH ST
Mailing Address - Street 2:SUITE #207
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166
Mailing Address - Country:US
Mailing Address - Phone:786-615-9879
Mailing Address - Fax:786-345-0620
Practice Address - Street 1:7902 NW 36TH ST
Practice Address - Street 2:SUITE #207
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166
Practice Address - Country:US
Practice Address - Phone:786-615-9879
Practice Address - Fax:786-345-0620
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT16561225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist