Provider Demographics
NPI:1548705635
Name:TREVINO, ALANA (LSW)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:TREVINO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:OH
Mailing Address - Zip Code:43449-1423
Mailing Address - Country:US
Mailing Address - Phone:419-764-4497
Mailing Address - Fax:
Practice Address - Street 1:2055 NAPOLEON RD UNIT 16B
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-4689
Practice Address - Country:US
Practice Address - Phone:419-764-4497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-27
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1600993104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker