Provider Demographics
NPI:1952999856
Name:PEARSON, TRISHA A
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:A
Last Name:PEARSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2036 EMERSON AVE # 1
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-3043
Mailing Address - Country:US
Mailing Address - Phone:937-296-6450
Mailing Address - Fax:
Practice Address - Street 1:2036 EMERSON AVE # 1
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-3043
Practice Address - Country:US
Practice Address - Phone:937-296-6450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant