Healthcare Provider Details

I. General information

NPI: 1053390062
Provider Name (Legal Business Name): NANCY L TRAWIN ED.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

758 N BROOKSIDE RD
WESCOSVILLE PA
18106-9715
US

IV. Provider business mailing address

758 N BROOKSIDE RD
WESCOSVILLE PA
18106-9715
US

V. Phone/Fax

Practice location:
  • Phone: 610-481-9161
  • Fax: 610-481-0088
Mailing address:
  • Phone: 610-481-9161
  • Fax: 610-481-0088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS-003353-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: