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Individual

MARCIA TRELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SPECIAL ED TEACHER

Contact information

Practice address
445 ATKINS AVE, BROOKLYN, NY 11208-4411
(718) 207-9839
Mailing address
445 ATKINS AVE, BROOKLYN, NY 11208-4411
(718) 207-9839

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
077252011
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1811310295
NY
Enumeration date
11/22/2016
Last updated
11/22/2016
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