Provider Demographics
NPI:1376086751
Name:ROSSYION, TREMAINE PAUL
Entity Type:Individual
Prefix:MR
First Name:TREMAINE
Middle Name:PAUL
Last Name:ROSSYION
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 MOSS ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70507-6113
Mailing Address - Country:US
Mailing Address - Phone:337-261-2300
Mailing Address - Fax:337-261-9080
Practice Address - Street 1:3405 MOSS ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-6113
Practice Address - Country:US
Practice Address - Phone:337-261-2300
Practice Address - Fax:337-261-9080
Is Sole Proprietor?:No
Enumeration Date:2016-12-02
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LA16086104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator