Provider Demographics
NPI:1871667030
Name:TRIOLO, DENNIS J (AUD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:J
Last Name:TRIOLO
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11529
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96931
Mailing Address - Country:US
Mailing Address - Phone:671-649-2902
Mailing Address - Fax:671-649-2905
Practice Address - Street 1:545 CHALAN SAN ANTONIO
Practice Address - Street 2:SUITE 305
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913
Practice Address - Country:US
Practice Address - Phone:671-649-2902
Practice Address - Fax:671-649-2905
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUSLA000003231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist