Provider Demographics
NPI:1760876460
Name:AGUERO-TROTTER, DIANNE MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DIANNE
Middle Name:MARIE
Last Name:AGUERO-TROTTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MRS
Other - First Name:DIANNE
Other - Middle Name:MARIE
Other - Last Name:TROTTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:43 FAIRFIELD AVENUE
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016
Mailing Address - Country:US
Mailing Address - Phone:908-377-4813
Mailing Address - Fax:
Practice Address - Street 1:400 SOUTH ORANGE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079
Practice Address - Country:US
Practice Address - Phone:973-761-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00464000103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical