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NPI Code Detail

MEDICARE: TRINNA STANFORD MA

MEDICARE:   TRINNA  STANFORD  MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker6723LA
2101Y00000XCounselor

General Provider Information

NPI Number : 1649643032
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRINNA STANFORD MA
Provider Business Mailing Address
First Line : 2729 BAYOU COOK DR
Second Line :
City : MARRERO
State : LA
Zip : 70072-8502
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6305 ELYSIAN FIELDS AVE
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70122-4245
Country : US
Telephone Number : 504-265-0996
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2015
Last Update Date : 11/05/2015

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Directions to “ TRINNA STANFORD MA” Practice Location

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