Provider Demographics
NPI:1962740951
Name:TROMBLEY, THERESA
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:TROMBLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 MERRIMACK ST BLG 9,
Mailing Address - Street 2:3RD FLOOR SUITE 355
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1740
Mailing Address - Country:US
Mailing Address - Phone:978-687-1617
Mailing Address - Fax:
Practice Address - Street 1:360 MERRIMACK ST BLG 9,
Practice Address - Street 2:3RD FLOOR SUITE 355
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-0184
Practice Address - Country:US
Practice Address - Phone:978-687-1617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical