MEDICARE: AIMEE TREZISE COCKBURN

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
1	106H00000X	Marriage & Family Therapist	M.2400298	OH

General Provider Information

NPI Number	:	1477405074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIMEE TREZISE COCKBURN

Provider Business Mailing Address
First Line	:	37303 HARVEST AVE
Second Line	:
City	:	AVON
State	:	OH
Zip	:	44011-2803
Country	:	US
Telephone Number	:	440-847-8505
Fax Number	:

Provider Business Practice Location Address
First Line	:	37303 HARVEST AVE
Second Line	:
City	:	AVON
State	:	OH
Zip	:	44011-2803
Country	:	US
Telephone Number	:	440-847-8505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2026
Last Update Date	:	02/14/2026

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Directions to “ AIMEE TREZISE COCKBURN ” Practice Location

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