MEDICARE: NANCY L TRAWIN ED.D.

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	103T00000X	Psychologist	PS-003353-L	PA

General Provider Information

NPI Number	:	1053390062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY L TRAWIN ED.D.

Provider Business Mailing Address
First Line	:	758 N BROOKSIDE RD
Second Line	:
City	:	WESCOSVILLE
State	:	PA
Zip	:	18106-9715
Country	:	US
Telephone Number	:	610-481-9161
Fax Number	:	610-481-0088

Provider Business Practice Location Address
First Line	:	758 N BROOKSIDE RD
Second Line	:
City	:	WESCOSVILLE
State	:	PA
Zip	:	18106-9715
Country	:	US
Telephone Number	:	610-481-9161
Fax Number	:	610-481-0088

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	07/09/2007

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