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Individual

AMANDA O TRUJILLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
5 PRIVATE DRIVE 1684, EL RITO, NM 87530
(505) 927-3910
Mailing address
PO BOX 218, EL RITO, NM 87530-0218
(505) 927-3910

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I-06983
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1750676953
NM
05
E7436
NM
Enumeration date
06/15/2011
Last updated
11/01/2023
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