Provider Demographics
NPI:1609391234
Name:DR. SUSIE O. TROXLER INC
Entity Type:Organization
Organization Name:DR. SUSIE O. TROXLER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:OZETTA
Authorized Official - Last Name:TROXLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:336-324-1610
Mailing Address - Street 1:PO BOX 41105
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27404-1105
Mailing Address - Country:US
Mailing Address - Phone:336-324-1610
Mailing Address - Fax:800-699-7219
Practice Address - Street 1:3405 W WENDOVER AVE STE E
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1525
Practice Address - Country:US
Practice Address - Phone:336-324-1610
Practice Address - Fax:800-699-7219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-04
Last Update Date:2017-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2790103T00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty