Provider Demographics
NPI:1508436049
Name:SCANLON, TROY WILLIAM (AUD)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:WILLIAM
Last Name:SCANLON
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20911 EARL ST STE 330
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4336
Mailing Address - Country:US
Mailing Address - Phone:888-405-2247
Mailing Address - Fax:
Practice Address - Street 1:20911 EARL ST STE 330
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4336
Practice Address - Country:US
Practice Address - Phone:888-405-2247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3603231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist