| NPI | 1063942423 |
|---|---|
| Former Name | LUPE TRUJILLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 03-03-02) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2021-10-11 |