Provider Demographics
NPI:1518364819
Name:TRENARY, ANGELA MARIE (TLMFT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:TRENARY
Suffix:
Gender:F
Credentials:TLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4089 21ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-6345
Mailing Address - Country:US
Mailing Address - Phone:319-364-1985
Mailing Address - Fax:
Practice Address - Street 1:4089 21ST AVE SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-6345
Practice Address - Country:US
Practice Address - Phone:319-364-1985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA075896106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist