Provider Information for 1609516210
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GLENNY TREJOS LCMHC
Sex: Female
NPI: 1609516210
Last Updated: 2022-04-19
Certification Date: 2022-04-19
Certification Date: 2022-04-19
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1609516210 | ||||||||
| Enumeration Date | 2022-03-31 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 11511 SW 145TH AVE MIAMI, FL 33186-6680 United States Phone: 305-519-7146 | Fax: | ||||||||
| Primary Practice Address | 11511 SW 145TH AVE MIAMI, FL 33186-6680 United States Phone: 305-519-7146 | Fax: | ||||||||
| Secondary Practice Address(es) | 3800 W BROWARD BLVD STE 100 | ||||||||
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