Provider Demographics
NPI:1730416132
Name:TRIMMER, THOMAS G (PHD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:G
Last Name:TRIMMER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 W WATERS AVE
Mailing Address - Street 2:SUITE 311
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2869
Mailing Address - Country:US
Mailing Address - Phone:813-931-8634
Mailing Address - Fax:813-514-1417
Practice Address - Street 1:3105 W WATERS AVE
Practice Address - Street 2:SUITE 311
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2869
Practice Address - Country:US
Practice Address - Phone:813-931-8634
Practice Address - Fax:813-514-1417
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5637103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist