Organization Name: | TRELLIS SERVICES, INC |
NPI Number: | 1497082176 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JUNE GOODMAN-KESSLER (DIRECTOR OF OUT PATIENT SERVICES) |
Mailing Address: | 164 Lake Front Dr Hunt Valley |
State: | MD US |
Postal Code: | 210302215 |
Phone Number: | 4107853845 |
Fax Number: | |
NPI Enumeration Date: | 11/17/2009 |
NPI Last Update Date: | 11/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 04277 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |