Healthcare Provider Details

I. General information

NPI: 1801221742
Provider Name (Legal Business Name): TRINA PERIN CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2013
Last Update Date: 09/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6642 BRANCH HILL GUINEA PIKE
LOVELAND OH
45140-9141
US

IV. Provider business mailing address

6642 BRANCH HILL GUINEA PIKE
LOVELAND OH
45140-9141
US

V. Phone/Fax

Practice location:
  • Phone: 513-791-1458
  • Fax: 513-791-4326
Mailing address:
  • Phone: 513-791-1458
  • Fax: 513-791-4326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP2648
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: