Provider Demographics
NPI:1023770997
Name:MACLEOD, TRISHA ANN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:ANN
Last Name:MACLEOD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 OLD ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:KUTZTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19530-9028
Mailing Address - Country:US
Mailing Address - Phone:484-602-8293
Mailing Address - Fax:
Practice Address - Street 1:1378 RED DALE RD
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-9464
Practice Address - Country:US
Practice Address - Phone:570-573-3293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC018013225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist