Provider Demographics
NPI:1275962086
Name:TRENT, TAMARA ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:ANN
Last Name:TRENT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-4010
Mailing Address - Country:US
Mailing Address - Phone:512-586-6587
Mailing Address - Fax:
Practice Address - Street 1:2235 N PEA RIDGE RD
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-4613
Practice Address - Country:US
Practice Address - Phone:512-586-6587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-02
Last Update Date:2016-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX581581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical