Provider Demographics
NPI:1790930840
Name:BROWN-TRIOLO, DENISE (PHD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:BROWN-TRIOLO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2054 S GREEN RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-4243
Mailing Address - Country:US
Mailing Address - Phone:216-291-9424
Mailing Address - Fax:216-291-9422
Practice Address - Street 1:2054 S GREEN RD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-4243
Practice Address - Country:US
Practice Address - Phone:216-291-9424
Practice Address - Fax:216-291-9422
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH1244488103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist