Provider Demographics
NPI:1174752604
Name:MEISSNER, DENISE LYN (OTR)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:LYN
Last Name:MEISSNER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:LYN
Other - Last Name:LACROIX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:806 CORAL RIDGE EAST
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-5489
Mailing Address - Country:US
Mailing Address - Phone:979-690-7926
Mailing Address - Fax:
Practice Address - Street 1:1318 MEMORIAL DRIVE
Practice Address - Street 2:BRAZOS VALLEY REHAB CENTER
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802
Practice Address - Country:US
Practice Address - Phone:979-776-2872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111279225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist