Provider Demographics
NPI:1598494627
Name:DEAR, TRENA MICHELLE
Entity Type:Individual
Prefix:
First Name:TRENA
Middle Name:MICHELLE
Last Name:DEAR
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 1:2874 CYCLORAMA DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-8330
Mailing Address - Country:US
Mailing Address - Phone:513-289-2487
Mailing Address - Fax:
Practice Address - Street 1:2874 CYCLORAMA DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-8330
Practice Address - Country:US
Practice Address - Phone:513-289-2487
Practice Address - Fax:513-389-0084
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care