Provider Demographics
NPI:1073644258
Name:DOW, TRINA M (ATR, BC,LPC)
Entity Type:Individual
Prefix:MS
First Name:TRINA
Middle Name:M
Last Name:DOW
Suffix:
Gender:F
Credentials:ATR, BC,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4917 CATHARINE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-2007
Mailing Address - Country:US
Mailing Address - Phone:215-748-0482
Mailing Address - Fax:215-662-8887
Practice Address - Street 1:3910 POWELTON AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4621
Practice Address - Country:US
Practice Address - Phone:215-662-8881
Practice Address - Fax:215-662-8887
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002867101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional