Provider Demographics
NPI:1083367494
Name:WINFREY, WILLIAM TREVOR
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:TREVOR
Last Name:WINFREY
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 1:7465 EASTERLY LN
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-4121
Mailing Address - Country:US
Mailing Address - Phone:901-949-0336
Mailing Address - Fax:
Practice Address - Street 1:7465 EASTERLY LN
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-4121
Practice Address - Country:US
Practice Address - Phone:901-949-0336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health