Provider Demographics
NPI:1043595184
Name:SCHULTZ, TRENA (OTR/L, CHT)
Entity Type:Individual
Prefix:MRS
First Name:TRENA
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 MEDPARK DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2734
Mailing Address - Country:US
Mailing Address - Phone:606-679-1761
Mailing Address - Fax:606-678-0971
Practice Address - Street 1:175 MEDPARK DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2734
Practice Address - Country:US
Practice Address - Phone:606-679-1761
Practice Address - Fax:606-678-0971
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY133742225X00000X
FLOT2488174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist