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NPI Code Detail

MEDICARE: DONNA TREBETS LSW

MEDICARE: DONNA TREBETS LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerS.0002937OH

General Provider Information

NPI Number : 1053937912
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA TREBETS LSW
Provider Business Mailing Address
First Line : 7063 W JEFFERSON DR
Second Line :
City : MENTOR
State : OH
Zip : 44060-4835
Country : US
Telephone Number : 440-520-6656
Fax Number :
Provider Business Practice Location Address
First Line : 29125 CHAGRIN BLVD
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-4622
Country : US
Telephone Number : 216-292-3999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2020
Last Update Date : 06/17/2020

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Directions to “ DONNA TREBETS LSW” Practice Location

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