Provider Demographics
NPI:1720348436
Name:TROST, STEPHANIE (MS, CCC-SLP, IBCLC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:TROST
Suffix:
Gender:F
Credentials:MS, CCC-SLP, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 CADMAN DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-1529
Mailing Address - Country:US
Mailing Address - Phone:610-436-3600
Mailing Address - Fax:610-436-3606
Practice Address - Street 1:911 CADMAN DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1529
Practice Address - Country:US
Practice Address - Phone:610-930-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-29
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174N00000X
PASL010857235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No174N00000XOther Service ProvidersLactation Consultant, Non-RN