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General NPI Number Information
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NPI Number | 1467885954
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Entity Type | Individual
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Provider Name | DR. SUSAN LYNN TROYANOS
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Gender | Female
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Dates
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Enumeration Date | 08/20/2013
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Last Update Date | 08/20/2013
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Provider Practice Location Address
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Address Line | 2476 NIMMO PKWY 115
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-2545
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Country | US
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Telephone | 757-685-7077
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Fax | 757-689-3422
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Provider Business Mailing Address
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Address Line | 2476 NIMMO PKWY 115
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-2545
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Country | US
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Telephone | 757-685-7077
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Fax | 757-689-3422
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0710101655
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License Number State | VA
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