MEDICARE: DR. JUDITH ANN TRENKAMP PHD

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	103TA0400X	Addiction (Substance Use Disorder) Psychologist	6301008277	MI

General Provider Information

NPI Number	:	1801006713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDITH ANN TRENKAMP PHD

Provider Business Mailing Address
First Line	:	2217 RHINE RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-3068
Country	:	US
Telephone Number	:	248-855-3921
Fax Number	:

Provider Business Practice Location Address
First Line	:	27650 FARMINGTON RD
Second Line	:	SUITE 100
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3350
Country	:	US
Telephone Number	:	248-821-3613
Fax Number	:

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

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	07/08/2007

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