Provider Demographics
NPI:1710481999
Name:LINDA M TRUJILLO
Entity Type:Organization
Organization Name:LINDA M TRUJILLO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:TRUJILLO
Authorized Official - Suffix:
Authorized Official - Credentials:PCSW
Authorized Official - Phone:307-631-0744
Mailing Address - Street 1:4526 MARBLE AVE
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-1896
Mailing Address - Country:US
Mailing Address - Phone:307-631-0744
Mailing Address - Fax:
Practice Address - Street 1:4526 MARBLE AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-1896
Practice Address - Country:US
Practice Address - Phone:307-631-0744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management