Provider Demographics
NPI:1134306533
Name:TRIMARCO, CARRIE (SLP)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:TRIMARCO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033
Mailing Address - Country:US
Mailing Address - Phone:146-970-8825
Mailing Address - Fax:
Practice Address - Street 1:2770 MAIN ST
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4302
Practice Address - Country:US
Practice Address - Phone:469-708-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113954235Z00000X
TX113594235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH99560058Medicaid