Provider Demographics
NPI:1063438489
Name:TRUCHANOWICZ, ROSEMARY A (MSW,LISW,BCD)
Entity type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:A
Last Name:TRUCHANOWICZ
Suffix:
Gender:F
Credentials:MSW,LISW,BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20325 CENTER RIDGE RD STE 628
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3554
Mailing Address - Country:US
Mailing Address - Phone:440-331-5570
Mailing Address - Fax:440-331-3221
Practice Address - Street 1:20325 CENTER RIDGE RD
Practice Address - Street 2:STE 628
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3572
Practice Address - Country:US
Practice Address - Phone:440-331-5570
Practice Address - Fax:440-331-3221
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI19071041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHTRSW4811Medicare ID - Type Unspecified