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General NPI Number Information
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NPI Number | 1619986106
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Entity Type | Individual
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Provider Name | GREGORY DALE TRAMMEL M.A., L.M.H.C.
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 11/30/2008
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Provider Practice Location Address
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Address Line | 12128 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5575
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Country | US
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Telephone | 352-592-7740
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Fax | 352-592-7742
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Provider Business Mailing Address
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Address Line | 10363 BELLTOWER ST
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City | SPRING HILL
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State | FL
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Zip | 34608-2000
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Country | US
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Telephone | 352-592-7740
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Fax | 352-592-7742
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 3560
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | MH3560
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License Number State | FL
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