Provider Demographics
NPI:1164023552
Name:TREZZA, MEAGHAN NICOLE
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:NICOLE
Last Name:TREZZA
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 1:709 N I ST APT 5
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-2052
Mailing Address - Country:US
Mailing Address - Phone:360-207-5773
Mailing Address - Fax:
Practice Address - Street 1:709 N I ST APT 5
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-2052
Practice Address - Country:US
Practice Address - Phone:360-207-5773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61326897101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health