Provider Demographics
NPI:1144555608
Name:YOUNGLOVE, TRENA (MS)
Entity type:Individual
Prefix:MRS
First Name:TRENA
Middle Name:
Last Name:YOUNGLOVE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7821 PINE MARSH CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7130
Mailing Address - Country:US
Mailing Address - Phone:407-903-0810
Mailing Address - Fax:
Practice Address - Street 1:7821 PINE MARSH CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7130
Practice Address - Country:US
Practice Address - Phone:407-903-0810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251S00000XAgenciesCommunity/Behavioral Health