Healthcare Provider Details

I. General information

NPI: 1710139621
Provider Name (Legal Business Name): DEBORAH RUTH TRENT MSED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH RUTH BUTZINE

II. Dates (important events)

Enumeration Date: 10/22/2008
Last Update Date: 10/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 W A J HWY
TALBOTT TN
37877
US

IV. Provider business mailing address

DEPARTMENT 888182
KNOXVILLE TN
37921
US

V. Phone/Fax

Practice location:
  • Phone: 423-587-7337
  • Fax: 423-586-0614
Mailing address:
  • Phone: 800-355-3565
  • Fax: 423-714-2355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: