Provider Demographics
NPI:1053866871
Name:TRUMPETER, NEVELYN NOBLIT (PHD)
Entity Type:Individual
Prefix:DR
First Name:NEVELYN
Middle Name:NOBLIT
Last Name:TRUMPETER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DAWN NEVELYN
Other - Middle Name:NOBLIT
Other - Last Name:TRUMPETER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1816 BULL ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2506
Mailing Address - Country:US
Mailing Address - Phone:803-422-0017
Mailing Address - Fax:
Practice Address - Street 1:1816 BULL ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2506
Practice Address - Country:US
Practice Address - Phone:803-422-0017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1408103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical