MEDICARE: DR. STEPHANIE JOYCE TRAYNOR PSYD

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
1	103TC0700X	Clinical Psychologist	B1-0000744	DE

General Provider Information

NPI Number	:	1043418916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE JOYCE TRAYNOR PSYD

Provider Business Mailing Address
First Line	:	5 BAYARD CT
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19805-2855
Country	:	US
Telephone Number	:	302-593-4675
Fax Number	:	302-235-2672

Provider Business Practice Location Address
First Line	:	1213 OLD LANCASTER PIKE
Second Line	:
City	:	HOCKESSIN
State	:	DE
Zip	:	19707-9560
Country	:	US
Telephone Number	:	302-593-4675
Fax Number	:	302-235-2672

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2007
Last Update Date	:	09/01/2010

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