Provider Demographics
NPI:1306304878
Name:PERKINS, TREVOR WAYNE
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:WAYNE
Last Name:PERKINS
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:PSC 454 BOX 2873
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09250-0029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:US ARMY HEALTH CLINIC ANSBACH
Practice Address - Street 2:URLASSTRASSE
Practice Address - City:ANSBACH
Practice Address - State:BAVARIA
Practice Address - Zip Code:91522
Practice Address - Country:DE
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2025-09-25
Deactivation Date:2022-08-07
Deactivation Code:
Reactivation Date:2022-09-20
Provider Licenses
StateLicense IDTaxonomies
VA0810008524103TC0700X
171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No171000000XOther Service ProvidersMilitary Health Care Provider