Provider Demographics
NPI:1861830473
Name:GOSS, TRISHA D (COTA/L)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:D
Last Name:GOSS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:D
Other - Last Name:GOSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COTA/L
Mailing Address - Street 1:122 SLOCUM RD
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:CT
Mailing Address - Zip Code:06248-1437
Mailing Address - Country:US
Mailing Address - Phone:860-455-3736
Mailing Address - Fax:
Practice Address - Street 1:122 SLOCUM RD
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:CT
Practice Address - Zip Code:06248-1437
Practice Address - Country:US
Practice Address - Phone:614-623-3571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-06
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT224251E00000X, 282N00000X, 310400000X, 314000000X, 225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No251E00000XAgenciesHome Health
No282N00000XHospitalsGeneral Acute Care Hospital
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics