Provider Demographics
NPI:1235952433
Name:TRAUSCH, MONICA
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:TRAUSCH
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 1:380 WEST RD
Mailing Address - Street 2:
Mailing Address - City:WATERBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04087-3515
Mailing Address - Country:US
Mailing Address - Phone:207-337-5927
Mailing Address - Fax:
Practice Address - Street 1:115 E AUGUSTA ST
Practice Address - Street 2:
Practice Address - City:MC CORMICK
Practice Address - State:SC
Practice Address - Zip Code:29835-8703
Practice Address - Country:US
Practice Address - Phone:813-926-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME21-1732432084P0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0005XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurodevelopmental Disabilities