Individual
TRINITY JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EMT
Contact information
Practice address
3615 FIR ST APT 2, EAST CHICAGO, IN 46312-2112
(773) 367-4856
Mailing address
3615 FIR ST APT 2, EAST CHICAGO, IN 46312-2112
(773) 367-4856
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
171400000X
Health & Wellness Coach
Primary
—
—
174H00000X
Health Educator
—
—
374K00000X
Religious Nonmedical Practitioner
—
—
Other
Enumeration date
03/10/2025
Last updated
03/10/2025
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