Individual
IAN ALEXANDER TRUJILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA, LBA
Contact information
Practice address
104 RIVERSIDE DR APT 304, MATAMORAS, PA 18336-1550
(631) 276-7264
Mailing address
104 RIVERSIDE DR APT 304, MATAMORAS, PA 18336-1550
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-68050
NY
Other
Enumeration date
06/27/2024
Last updated
06/27/2024
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