MEDICARE: MS. JENNIFER TROTTER MA

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	101YM0800X	Mental Health Counselor	MH10052	FL
2	106H00000X	Marriage & Family Therapist	MT2444	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12093435	OTHER	FL	CAQH

General Provider Information

NPI Number	:	1518272194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER TROTTER MA

Provider Business Mailing Address
First Line	:	102 WHITECAPS CIR
Second Line	:
City	:	MAITLAND
State	:	FL
Zip	:	32751-5852
Country	:	US
Telephone Number	:	407-353-1484
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 E SYBELIA AVE
Second Line	:	SUITE 380
City	:	MAITLAND
State	:	FL
Zip	:	32751-4763
Country	:	US
Telephone Number	:	407-353-1484
Fax Number	:

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

Provider Enumeration Date	:	08/08/2010
Last Update Date	:	12/03/2016

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Directions to “ MS. JENNIFER TROTTER MA” Practice Location

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