Provider Demographics
NPI:1508261587
Name:TROTTER, MERRI ELIZABETH (OTR)
Entity Type:Individual
Prefix:
First Name:MERRI
Middle Name:ELIZABETH
Last Name:TROTTER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 255
Mailing Address - Street 2:
Mailing Address - City:BIRCH TREE
Mailing Address - State:MO
Mailing Address - Zip Code:65438-9648
Mailing Address - Country:US
Mailing Address - Phone:573-996-6275
Mailing Address - Fax:
Practice Address - Street 1:RR 2 BOX 2215
Practice Address - Street 2:
Practice Address - City:BIRCH TREE
Practice Address - State:MO
Practice Address - Zip Code:65438-9215
Practice Address - Country:US
Practice Address - Phone:573-292-3212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002028082225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist