Individual
TRUJILLO J AMY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MRC, LPC, LVRC, CRC
Contact information
Practice address
314 S 450 W, HEYBURN, ID 83336-8693
(208) 650-6961
Mailing address
314 S 450 W, HEYBURN, ID 83336-8693
(208) 650-6961
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-7738
ID
Other
Enumeration date
03/11/2021
Last updated
03/11/2021
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