Provider Demographics
NPI:1447358171
Name:TRYLCH, SCOTT WILLIAM (EDD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:WILLIAM
Last Name:TRYLCH
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:579 N WILDERNESS DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-8628
Mailing Address - Country:US
Mailing Address - Phone:989-631-6990
Mailing Address - Fax:
Practice Address - Street 1:120 N MICHIGAN AVE
Practice Address - Street 2:220
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-4236
Practice Address - Country:US
Practice Address - Phone:989-790-5988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301001438103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling