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Individual

MAXINE E. TRENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC/LMFT

Contact information

Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
2401 S 31ST ST, TEMPLE, TX 76508
(254) 724-2111

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
10871
TX
106H00000X
Marriage & Family Therapist
Primary
2208
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0277816-03
TX
01
84716L
BLUE SHIELD
TX
Enumeration date
04/10/2006
Last updated
08/03/2010
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