Basic Information
| Provider Information | |||||||||
| NPI: | 1023332061 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REED | ||||||||
| FirstName: | TRENISE | ||||||||
| MiddleName: | SAVERIN | ||||||||
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| Credential: | OT | ||||||||
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| OtherLastName: | SAVERIN | ||||||||
| OtherFirstName: | TRENISE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 950 E COUNTY LINE RD | ||||||||
| Address2: | SUITE E | ||||||||
| City: | RIDGELAND | ||||||||
| State: | MS | ||||||||
| PostalCode: | 391571928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6018538747 | ||||||||
| FaxNumber: | 6018984761 | ||||||||
| Practice Location | |||||||||
| Address1: | 950 E COUNTY LINE RD | ||||||||
| Address2: | SUITE E | ||||||||
| City: | RIDGELAND | ||||||||
| State: | MS | ||||||||
| PostalCode: | 391571928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6018538747 | ||||||||
| FaxNumber: | 6018984761 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2010 | ||||||||
| LastUpdateDate: | 09/22/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OTT.200237 | LA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225X00000X | OT2679 | MS | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.