Provider Demographics
NPI:1063531143
Name:VISALLI, TRISHA A (OTR)
Entity type:Individual
Prefix:MISS
First Name:TRISHA
Middle Name:A
Last Name:VISALLI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MRS
Other - First Name:TRISHA
Other - Middle Name:VISALLI
Other - Last Name:WILKOCZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR
Mailing Address - Street 1:2541 PEACHTREE DR
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-5440
Mailing Address - Country:US
Mailing Address - Phone:215-453-7353
Mailing Address - Fax:
Practice Address - Street 1:1660 EASTON RD
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-1202
Practice Address - Country:US
Practice Address - Phone:215-345-3272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC009262225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist