Provider Demographics
NPI:1871073684
Name:TREPANIER, ELAINE (OBHP)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:TREPANIER
Suffix:
Gender:F
Credentials:OBHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 E WASHINGTON ST STE 600
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-2692
Mailing Address - Country:US
Mailing Address - Phone:317-371-0099
Mailing Address - Fax:317-634-3907
Practice Address - Street 1:603 E WASHINGTON ST STE 600
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-2692
Practice Address - Country:US
Practice Address - Phone:317-371-0099
Practice Address - Fax:317-634-3907
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker