Provider Demographics
NPI:1073896940
Name:TRENT, GREGORY JERMAINE
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:JERMAINE
Last Name:TRENT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 W APOLLO RD APT 1423
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-6312
Mailing Address - Country:US
Mailing Address - Phone:214-995-3051
Mailing Address - Fax:
Practice Address - Street 1:2321 W APOLLO RD APT 1423
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-6312
Practice Address - Country:US
Practice Address - Phone:214-995-3051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor