Provider Demographics
NPI:1376986950
Name:TRINCIA-FITZGERALD, TRISH L (LBS)
Entity Type:Individual
Prefix:MRS
First Name:TRISH
Middle Name:L
Last Name:TRINCIA-FITZGERALD
Suffix:
Gender:F
Credentials:LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 CRESTPOINT DR
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-5668
Mailing Address - Country:US
Mailing Address - Phone:302-598-9598
Mailing Address - Fax:
Practice Address - Street 1:40 CRESTPOINT DR
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-5668
Practice Address - Country:US
Practice Address - Phone:302-598-9598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-12
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000042103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst