Provider Demographics
NPI:1558096859
Name:TROOP, MARNI (MFTA)
Entity Type:Individual
Prefix:
First Name:MARNI
Middle Name:
Last Name:TROOP
Suffix:
Gender:F
Credentials:MFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 BROWNSTONE RDG
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-3669
Mailing Address - Country:US
Mailing Address - Phone:603-203-1669
Mailing Address - Fax:
Practice Address - Street 1:265 BROWNSTONE RDG
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-3669
Practice Address - Country:US
Practice Address - Phone:603-203-1669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT097.0135210101YP2500X, 106H00000X
CT3072106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional