Provider Demographics
NPI:1144432550
Name:DEVRIES, THERESA MARIE (MS OTRL)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:MARIE
Last Name:DEVRIES
Suffix:
Gender:F
Credentials:MS OTRL
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:
Other - Last Name:DORSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1661 SE 31ST ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0741
Mailing Address - Country:US
Mailing Address - Phone:352-619-0790
Mailing Address - Fax:
Practice Address - Street 1:1661 SE 31ST ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0741
Practice Address - Country:US
Practice Address - Phone:352-619-0790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-06
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT13713225X00000X
MD04748225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT13713OtherLICENSE