Provider Demographics
NPI:1467714485
Name:DUPREE, TRINTH UDONN
Entity Type:Individual
Prefix:
First Name:TRINTH
Middle Name:UDONN
Last Name:DUPREE
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 1:3920 W ANN RD
Mailing Address - Street 2:100
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-3839
Mailing Address - Country:US
Mailing Address - Phone:702-542-9158
Mailing Address - Fax:
Practice Address - Street 1:3920 W ANN RD
Practice Address - Street 2:100
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-3839
Practice Address - Country:US
Practice Address - Phone:702-542-9158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner