Doctor Name: | MARGIE TRUJILLO |
NPI Number: | 1003875782 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD, LPCC |
License Number: | 1183 |
Business Practice Address: | 1930 San Juan Blvd Suite K Farmington, NM - 874012245 |
Business Phone Number: | 5053267679 |
Business Fax Number: | 5053242259 |
Mailing Address: | Po Box 15160, FARMINGTON |
State: | NM |
Postal Code: | 874015160 |
Phone Number: | 5053242258 |
Fax Number: | 5053242259 |
NPI Enumeration Date: | 03/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SP0807X |
License Number: | 1183 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Psych/Mental Health, Child & Adolescent |
Taxonomy Definition: |