Provider Demographics
NPI:1114604089
Name:TRAPP, CECILIA RENEE
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:RENEE
Last Name:TRAPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 BERKSHIRE DR STE B
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-1859
Mailing Address - Country:US
Mailing Address - Phone:803-369-4957
Mailing Address - Fax:
Practice Address - Street 1:300 BERKSHIRE DR STE B
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-1859
Practice Address - Country:US
Practice Address - Phone:803-369-4957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management