Provider Demographics
NPI:1952059198
Name:TRUGLIO, CARLY ALEXANDRA (MA-CCC)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:ALEXANDRA
Last Name:TRUGLIO
Suffix:
Gender:F
Credentials:MA-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 BIRCHWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07642-1303
Mailing Address - Country:US
Mailing Address - Phone:012-336-2901
Mailing Address - Fax:
Practice Address - Street 1:23 BIRCHWOOD LN
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:NJ
Practice Address - Zip Code:07642-1303
Practice Address - Country:US
Practice Address - Phone:201-336-2901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01074900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist