Provider Demographics
NPI:1801221742
Name:PERIN, TRINA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:
Last Name:PERIN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6642 BRANCH HILL GUINEA PIKE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-9141
Mailing Address - Country:US
Mailing Address - Phone:513-791-1458
Mailing Address - Fax:513-791-4326
Practice Address - Street 1:6642 BRANCH HILL GUINEA PIKE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-9141
Practice Address - Country:US
Practice Address - Phone:513-791-1458
Practice Address - Fax:513-791-4326
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP2648235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2625118Medicaid
OH2625118Medicaid