Provider Demographics
NPI:1740614379
Name:TREPANIER, KATIE
Entity Type:Individual
Prefix:MISS
First Name:KATIE
Middle Name:
Last Name:TREPANIER
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 1:8850 GOODRICH RD
Mailing Address - Street 2:APT. 201
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437-1649
Mailing Address - Country:US
Mailing Address - Phone:218-766-4818
Mailing Address - Fax:
Practice Address - Street 1:8850 GOODRICH RD
Practice Address - Street 2:APT. 201
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437-1649
Practice Address - Country:US
Practice Address - Phone:218-766-4818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health