Individual
KENNETH TRIVISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25111 COUNTRY CLUB BLVD, SUITE 290, NORTH OLMSTED, OH 44070-5345
(440) 614-2520
(440) 614-2526
Mailing address
24800 HIGHPOINT RD, BEACHWOOD, OH 44122-6041
(216) 831-6611
(216) 831-2726
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E0000375
OH
Other
Enumeration date
06/10/2006
Last updated
07/08/2007
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