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General NPI Number Information
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NPI Number | 1285445601
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Entity Type | Individual
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Provider Name | AUBREY KAY TRISSEL
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Gender | Female
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 1649 BRICE RD STE C
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City | REYNOLDSBURG
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State | OH
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Zip | 43068-2796
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Country | US
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Telephone | 614-300-5878
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Fax |
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Provider Business Mailing Address
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Address Line | 6618 STREAMSIDE DR
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City | GALENA
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State | OH
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Zip | 43021-7617
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Country | US
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Telephone | 614-715-7913
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | S.2504093-TRNE
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License Number State | OH
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