Provider Demographics
NPI:1689070187
Name:TRIPLETT OCCUPATIONAL THERAPY SERVICES
Entity Type:Organization
Organization Name:TRIPLETT OCCUPATIONAL THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:TRIPLETT
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:713-295-1975
Mailing Address - Street 1:PO BOX 3409
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75802-3409
Mailing Address - Country:US
Mailing Address - Phone:713-295-1975
Mailing Address - Fax:
Practice Address - Street 1:1100 E ANGELINA ST
Practice Address - Street 2:
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75801-4608
Practice Address - Country:US
Practice Address - Phone:713-295-1975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113064251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health