Provider Demographics
NPI:1184941205
Name:METZ, TRICIA ANN (COTA)
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:ANN
Last Name:METZ
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2170 GLEN MEADOW DR
Mailing Address - Street 2:3
Mailing Address - City:RISING SUN
Mailing Address - State:IN
Mailing Address - Zip Code:47040-9094
Mailing Address - Country:US
Mailing Address - Phone:260-710-5423
Mailing Address - Fax:
Practice Address - Street 1:405 RIO VISTA LN
Practice Address - Street 2:
Practice Address - City:RISING SUN
Practice Address - State:IN
Practice Address - Zip Code:47040-9497
Practice Address - Country:US
Practice Address - Phone:812-438-2219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32001673A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant