Provider Demographics
NPI:1093217523
Name:TRENT, BRIDGET ANN (RD)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:ANN
Last Name:TRENT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8851 EDGEHILL RD
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-6203
Mailing Address - Country:US
Mailing Address - Phone:920-606-5625
Mailing Address - Fax:
Practice Address - Street 1:35900 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4623
Practice Address - Country:US
Practice Address - Phone:440-953-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7065133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered