Provider Demographics
NPI:1891072625
Name:TRAYNOR, MARION PATRICIA (MS, CCC-SLP, TSHH)
Entity Type:Individual
Prefix:MS
First Name:MARION
Middle Name:PATRICIA
Last Name:TRAYNOR
Suffix:
Gender:F
Credentials:MS, CCC-SLP, TSHH
Other - Prefix:MISS
Other - First Name:MARION
Other - Middle Name:PATRICIA
Other - Last Name:TRAYNOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP, TSHH
Mailing Address - Street 1:38 POPLAR PL
Mailing Address - Street 2:GUGGENHEIM SCHOOL
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1858
Mailing Address - Country:US
Mailing Address - Phone:516-767-5250
Mailing Address - Fax:
Practice Address - Street 1:38 POPLAR PL
Practice Address - Street 2:GUGGENHEIM SCHOOL
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-1858
Practice Address - Country:US
Practice Address - Phone:516-767-5250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007035-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist