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Individual

MARIA E TREVINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
914 E BROADWAY, 2ND FLOOR, LOUISVILLE, KY 40204-1037
(502) 589-8600
(502) 589-8771
Mailing address
101 W. MUHAMMAD ALI BLVD, LOUISVILLE, KY 40202

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1711
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100284620
KY
Enumeration date
09/25/2006
Last updated
03/05/2015
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