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General NPI Number Information
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NPI Number | 1801260856
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Entity Type | Individual
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Provider Name | KELSEY MARIE TRINKA
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Gender | Female
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Dates
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Enumeration Date | 11/13/2015
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 6862 ELM ST STE 120
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City | MC LEAN
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State | VA
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Zip | 22101-3862
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Country | US
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Telephone | 703-748-3300
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Fax | 703-749-3311
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Provider Business Mailing Address
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Address Line | 6862 ELM ST STE 120
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City | MC LEAN
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State | VA
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Zip | 22101-3862
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Country | US
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Telephone |
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Fax |
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 2201001707
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 000157
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License Number State | DC
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