Provider Demographics
NPI:1669084562
Name:TRINH, ENJOLIE-ROSE MULLER
Entity type:Individual
Prefix:
First Name:ENJOLIE-ROSE
Middle Name:MULLER
Last Name:TRINH
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 1:160 ELEMEDA ST
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-1846
Mailing Address - Country:US
Mailing Address - Phone:616-298-9637
Mailing Address - Fax:
Practice Address - Street 1:160 ELEMEDA ST
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-1846
Practice Address - Country:US
Practice Address - Phone:616-298-9637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2022-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451022606101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health