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Individual

JOSEPHINE T TRUJILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
PMG KASEMAN BEHAVIORAL MEDICINE, 1325 WYOMING NE, ALBUQUERQUE, NM 87112
(505) 291-5300
(505) 291-5303
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-1341
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
98139
NM
Enumeration date
08/31/2006
Last updated
06/24/2015
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