Provider Demographics
NPI:1730504671
Name:DORRIES, TRISHA L (MSOTR/L)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:L
Last Name:DORRIES
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:L
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOTR/L
Mailing Address - Street 1:45 E LOCKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WEBSTER GROVES
Mailing Address - State:MO
Mailing Address - Zip Code:63119-3050
Mailing Address - Country:US
Mailing Address - Phone:314-918-7300
Mailing Address - Fax:314-227-7285
Practice Address - Street 1:45 E LOCKWOOD AVE
Practice Address - Street 2:
Practice Address - City:WEBSTER GROVES
Practice Address - State:MO
Practice Address - Zip Code:63119-3050
Practice Address - Country:US
Practice Address - Phone:314-918-7300
Practice Address - Fax:314-227-7285
Is Sole Proprietor?:No
Enumeration Date:2014-03-01
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004457225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist