Provider Demographics
NPI:1104343110
Name:TRISCHLER, MATTHEW ALBERT
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ALBERT
Last Name:TRISCHLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SAINT ANDREWS RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-5977
Mailing Address - Country:US
Mailing Address - Phone:989-401-9020
Mailing Address - Fax:989-401-9021
Practice Address - Street 1:300 SAINT ANDREWS RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-5977
Practice Address - Country:US
Practice Address - Phone:989-401-9020
Practice Address - Fax:989-401-9021
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician