Doctor Name: | VENTURA TRENT |
NPI Number: | 1134513104 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 086560 |
Business Practice Address: | 50 Drake Ave Bellport, NY - 117131014 |
Business Phone Number: | 6318036134 |
Business Fax Number: | |
Mailing Address: | Po Box 294, BELLPORT |
State: | NY |
Postal Code: | 117130294 |
Phone Number: | 6318036134 |
Fax Number: | |
NPI Enumeration Date: | 03/26/2015 |
NPI Last Update Date: | 03/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | 086560 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |