Provider Demographics
NPI:1265877716
Name:TRENTHAM, CAMERON COOKE
Entity type:Individual
Prefix:MRS
First Name:CAMERON
Middle Name:COOKE
Last Name:TRENTHAM
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 1:2848 MERIDIAN POINT LN
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33812-5829
Mailing Address - Country:US
Mailing Address - Phone:863-701-7343
Mailing Address - Fax:
Practice Address - Street 1:2848 MERIDIAN POINT LN
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33812-5829
Practice Address - Country:US
Practice Address - Phone:863-701-7343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist