Doctor Name: | MRS. CANDI DAWN TRENT |
NPI Number: | 1215298542 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED., LPC CANDIDATE |
License Number: | |
Business Practice Address: | 1303 Lynn Ln Idabel, OK - 747456845 |
Business Phone Number: | 5802867025 |
Business Fax Number: | 5802867436 |
Mailing Address: | 902 E Lincoln Rd, IDABEL |
State: | OK |
Postal Code: | 747457337 |
Phone Number: | 5802862600 |
Fax Number: | 5802861087 |
NPI Enumeration Date: | 06/04/2012 |
NPI Last Update Date: | 06/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |