Provider Demographics
NPI:1821487117
Name:TRISLER, AMBER LEIGH (LCOTA)
Entity Type:Individual
Prefix:MISS
First Name:AMBER
Middle Name:LEIGH
Last Name:TRISLER
Suffix:
Gender:F
Credentials:LCOTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2185 LONE CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71295-6447
Mailing Address - Country:US
Mailing Address - Phone:318-481-3411
Mailing Address - Fax:
Practice Address - Street 1:110 SERIO BLVD
Practice Address - Street 2:
Practice Address - City:FERRIDAY
Practice Address - State:LA
Practice Address - Zip Code:71334-2013
Practice Address - Country:US
Practice Address - Phone:318-757-8671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTA.200471224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant