Provider Demographics
NPI:1881009819
Name:TRUJILLO, JULIE ANN (LPC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 PEEVY ST STE A
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-3227
Mailing Address - Country:US
Mailing Address - Phone:970-640-0703
Mailing Address - Fax:
Practice Address - Street 1:359 PEEVY ST STE A
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-3227
Practice Address - Country:US
Practice Address - Phone:970-640-0703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-28
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006568101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional