Doctor Name: | MS. ELAINE L DETRUJILLO |
NPI Number: | 1023145778 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA., CCC-SLP |
License Number: | 1141 |
Business Practice Address: | 505 S Main St Suite 249 Las Cruces, NM - 880011206 |
Business Phone Number: | 5055275823 |
Business Fax Number: | 5055275886 |
Mailing Address: | 505 S Main St, Suite 249 LAS CRUCES |
State: | NM |
Postal Code: | 880011206 |
Phone Number: | 5055275823 |
Fax Number: | 5055275886 |
NPI Enumeration Date: | 02/28/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1141 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |