Provider Demographics
NPI:1356468292
Name:PARAISO, TRIXIE BERNARDO (PT)
Entity type:Individual
Prefix:MISS
First Name:TRIXIE
Middle Name:BERNARDO
Last Name:PARAISO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2680 EUCLID HEIGHTS BLVD
Mailing Address - Street 2:APT 203-E
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-2865
Mailing Address - Country:US
Mailing Address - Phone:216-632-2116
Mailing Address - Fax:
Practice Address - Street 1:2680 EUCLID HEIGHTS BLVD
Practice Address - Street 2:APT 203-E
Practice Address - City:CLEVELAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44106-2865
Practice Address - Country:US
Practice Address - Phone:216-632-2116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.011340225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist