Provider Demographics
NPI:1043817489
Name:COTE, TREVOR ALLAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:ALLAN
Last Name:COTE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 CHURCH ST # 2
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02452-5618
Mailing Address - Country:US
Mailing Address - Phone:401-862-8803
Mailing Address - Fax:
Practice Address - Street 1:137 NEWBURY ST # 6B
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2912
Practice Address - Country:US
Practice Address - Phone:401-862-8803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11360103TC1900X, 103TE1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & SportsGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling