Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1053776609 |
---|---|
Provider Name | Gina Trolio |
First Address | Upper Nyack, NY 10960 |
Second Address | Upper Nyack, NY 10960 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2015 |
Last Update Date | 28/12/2015 |