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NPI Code Detail

MEDICARE: KRISTINA ANNE TRAHAN MSW

MEDICARE:   KRISTINA ANNE TRAHAN  MSW
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 Worker6801097786MI

General Provider Information

NPI Number : 1578815635
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA ANNE TRAHAN MSW
Provider Business Mailing Address
First Line : 2316 CRANBERRY TER
Second Line :
City : SILVER SPRING
State : MD
Zip : 20906-1045
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5270 NORTHLAND DR NE STE B
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49525-1073
Country : US
Telephone Number : 616-915-4769
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2012
Last Update Date : 05/09/2022

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Directions to “ KRISTINA ANNE TRAHAN MSW” Practice Location

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