Provider Demographics
NPI:1093096042
Name:TROIA, JACLYN MARIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:JACLYN
Middle Name:MARIE
Last Name:TROIA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:961 MARCON BLVD
Mailing Address - Street 2:SUITE 312
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18109-9521
Mailing Address - Country:US
Mailing Address - Phone:610-266-0610
Mailing Address - Fax:
Practice Address - Street 1:961 MARCON BLVD
Practice Address - Street 2:SUITE 312
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18109-9521
Practice Address - Country:US
Practice Address - Phone:610-266-0610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-05
Last Update Date:2011-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006012101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional