Provider Demographics
NPI:1427760859
Name:TREBELLA, CAITLYN LEE
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:LEE
Last Name:TREBELLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3708 OAKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420-3136
Mailing Address - Country:US
Mailing Address - Phone:330-553-7446
Mailing Address - Fax:
Practice Address - Street 1:12573 CHILLICOTHE RD
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026-2536
Practice Address - Country:US
Practice Address - Phone:440-313-7929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01131103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst