Provider Demographics
NPI:1861975351
Name:TROSA, MARIEL KATHERINE (MS, CF-SLP)
Entity type:Individual
Prefix:MRS
First Name:MARIEL
Middle Name:KATHERINE
Last Name:TROSA
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:MISS
Other - First Name:MARIEL
Other - Middle Name:KATHERINE
Other - Last Name:GUBENSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:109 WIND HAVEN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-8010
Mailing Address - Country:US
Mailing Address - Phone:859-224-2273
Mailing Address - Fax:
Practice Address - Street 1:541 GARDNER RD
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-1827
Practice Address - Country:US
Practice Address - Phone:607-739-6347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program