1619244639 NPI number — MS. TRISCH ANNE MURRAY M.ED., CCC-SLP

Table of content: MS. TRISCH ANNE MURRAY M.ED., CCC-SLP (NPI 1619244639)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619244639 NPI number — MS. TRISCH ANNE MURRAY M.ED., CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURRAY
Provider First Name:
TRISCH
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.ED., CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SAMPLE
Provider Other First Name:
TRISCH
Provider Other Middle Name:
ANNE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M. ED., CCC-SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1619244639
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5091 N SOMERSET LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALPHARETTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30004-3846
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-536-0074
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5091 N SOMERSET LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALPHARETTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30004-3846
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-536-0074
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/18/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SLP007452 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: SLP007452 . This is a "GA SLP LICENSE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".




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